Podcast
Questions and Answers
A child with tachycardia and altered mental status shows a narrow complex on the ECG. After establishing vascular access, what is the MOST appropriate initial medication and dosage?
A child with tachycardia and altered mental status shows a narrow complex on the ECG. After establishing vascular access, what is the MOST appropriate initial medication and dosage?
- Administer adenosine 0.2 mg/kg rapid IV/IO push, not to exceed 12 mg. (correct)
- Perform synchronized cardioversion starting at 2 J/kg.
- Administer adenosine 0.1 mg/kg rapid IV/IO push, not to exceed 6 mg.
- Administer amiodarone 5 mg/kg IV/IO push.
A child presents with tachycardia, a narrow QRS complex, and altered mental status failing to respond to initial doses of adenosine. There is no rhythm change. What intervention should be prioritized?
A child presents with tachycardia, a narrow QRS complex, and altered mental status failing to respond to initial doses of adenosine. There is no rhythm change. What intervention should be prioritized?
- Administer amiodarone 5 mg/kg IV/IO over 20-60 minutes.
- Perform vagal maneuvers, such as carotid massage.
- Administer a second dose of adenosine at 0.3 mg/kg.
- Initiate synchronized cardioversion starting at 0.5 to 1 J/kg. (correct)
During synchronized cardioversion on a child with tachycardia, the first attempt at 0.5 J/kg is unsuccessful. What is the next appropriate step?
During synchronized cardioversion on a child with tachycardia, the first attempt at 0.5 J/kg is unsuccessful. What is the next appropriate step?
- Administer lidocaine 1 mg/kg IV/IO.
- Increase the energy to 2 J/kg for the next attempt. (correct)
- Immediately administer epinephrine 0.01 mg/kg IV/IO.
- Switch to unsynchronized defibrillation at 4 J/kg.
What is the recommended maximum single dose of adenosine for a child experiencing tachycardia?
What is the recommended maximum single dose of adenosine for a child experiencing tachycardia?
A child with tachycardia is about to undergo synchronized cardioversion. What medication should be considered for sedation prior to the procedure?
A child with tachycardia is about to undergo synchronized cardioversion. What medication should be considered for sedation prior to the procedure?
Flashcards
Pediatric Tachycardia
Pediatric Tachycardia
Heart rate is abnormally high for a child's age.
Narrow Complex Tachycardia
Narrow Complex Tachycardia
ECG measurement indicating the duration of the QRS complex is less than or equal to 0.11 seconds.
Initial Actions for Tachycardia
Initial Actions for Tachycardia
Includes connecting the patient to a cardiac monitor and establishing intravenous (IV) or intraosseous (IO) access.
Adenosine
Adenosine
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Synchronized Cardioversion
Synchronized Cardioversion
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Study Notes
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Pediatric Tachycardia with Mental Status Changes and No Palpable Pulses Guidelines
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Narrow Complex: ≤0.11 Sec
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General Pediatric Assessment
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Cardiac monitor
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Vascular Access
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If IV established, administer ADENOSINE 0.2 mg/kg rapid IV/IO push, not to exceed 12 mg
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Rhythm change?
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No:
- Synchronized Cardioversion: start at 0.5 to 1 J/kg; may use 2 J/kg if unsuccessful
- Consider sedation ETOMIDATE 0.15 mg/kg IV/IO
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Rhythm change?
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Description
Guidelines for pediatric tachycardia with mental status changes. Includes assessment, cardiac monitoring and vascular access. Discusses Adenosine and synchronized cardioversion.
