What are the PALS recommendations for bradycardia? • Any intravascularly (IV or IO route) administered dose should be given as a standard dose (0.01 mg/kg). This dose is generally delivered as 0.1 mL/kg of a 1:10,000 solution of epinephrine. • Any doses administered by the ETT should be given as higher doses (0.1 mg/kg). This can be …
What are the PALS recommendations for pulseless arrest (PEA, asystole)? • Give epinephrine for PEA or asystole intravascularly (IV or IO route) as a standard dose (0.01 mg/kg). This can be delivered as 0.1 mL/kg of a 1:10,000 solution of epinephrine. Use of vasopressin is considered class indeterminate (not enough evidence to recommend for or against) in pediatric …
What role does drug therapy play in pediatric resuscitation? Drug therapy during resuscitation is reserved for patients who do not respond adequately to the ABCs. Other than oxygen, most pediatric resuscitations require few drugs. Other useful chemical agents include the following: • Epinephrine (to increase heart rate, myocardial contractility, and systemic vascular resistance) • Atropine (to increase …
Has opinion about the use of intraosseous (IO) access in recent years changed? Yes. Although IO needle placement should never be taken lightly, as it is painful and time-limited in its effectiveness, the literature increasingly supports its use as an important primary vascular access method in emergencies. Underutilization may be due to fears of complications …
What role does drug therapy play in pediatric resuscitation? Drug therapy during resuscitation is reserved for patients who do not respond adequately to the ABCs. Other than oxygen, most pediatric resuscitations require few drugs. Other useful chemical agents include the following: • Epinephrine (to increase heart rate, myocardial contractility, and systemic vascular resistance) • Atropine (to increase …
What are the do’s and don’ts surrounding intraosseous infusion? Although there is no age limit for use of IO infusion, it may be easier to accomplish in younger patients, whose bones are less calcified. Remember that IO infusion was developed in the 1930s as a technique of vascular access in adults. Numerous studies using adult …
Why does intraosseous infusion work? The bone marrow serves as a “stiff” vascular bed. It is composed of interconnected sinusoids that are fed and drained by veins that traverse the cortex of the bone and connect with the central circulation. Fluids infused anywhere into the marrow cavity enter these vascular channels and find their way …