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· Bradycardia is often the final response to hypoxia.
· A preterminal rhythm leading to asystole.
· Oxygen, with attention to airway and inflation.
· Epinephrine 10 micrograms/kg IV
· May require atropine 20 micrograms/kg IV (minimum 100 micrograms; maximum 1mg) if triggered by vagal stimulation.
· Heart rate can be as high as 220/min in an infant, but not higher.
· Caused by fever, pain, and shock.
Treat the cause.
· The most common primary arrhythmia in infancy and childhood.
· Onset sudden. Heart rate: >220/min in infants; >180/min in children over 3yrs.
· Rhythm is regular and P waves may not be visible.
· Infants may present with shock, sweatiness, and poor feeding.
· Rare in children; caused by primary cardiac problem or overdose.
· Heart rate: between 120 and 250/min.
· Rhythm is almost regular, but QRS is wide (>2 small squares).
· Pulse present: amiodarone 5mg/kg; synchronized shock.
· Pulseless: treat as for VF.
· Mainly caused by hypothermia and drug overdose.
· Found in 27% of all paediatric in-hospital arrests.
· Mainly caused by hypoxia and acidosis.
· 60% of all paediatric arrests.
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