Rhythm disturbances
.
·
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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