Pediatric bradycardia protocol

Question 1

What is most bradycardia related to in pediatric patients?

Answer 1

Hypoxia, and will usually respond to oxygenation.

Question 2

What are the first three steps for treating unstable bradycardia in pediatric patients?

Answer 2

Aggressive oxygenation and ventilation

Compressions on heart rates less than 60 bpm

Length based tape

Question 3

What is the rate and milliamp required for transcutaneous pacing? When is transcutaneous pacing indicated in pediatric bradycardia?

Answer 3

The rate is 80 to 100, and it should be done at 60 to 80 mA.

This treatment is indicated only after attempt to use chemical means to increase heart rate.

Question 4

What is the Epinephrine bolus dose for pediatric bradycardia?

Answer 4

.01 mg/kg (.1ml/kg) of 1:10,000 in 5–10 ml saline every 3-5 minutes

Question 5

What is the dose for atropine in pediatric bradycardia? Every how often should I be given?

Answer 5

.02 mg/kg
Minimum dose: .1 mg
Maximum dose: .5 mg
Maximum adolescent dose: 1 mg
Repeat only one time after 3 to 5 minutes if necessary.

Question 6

What is the pediatric epinephrine infusion dose for bradycardia?

Answer 6

.05-1 mcg/kg/min

Titrate to adequate heart rate/blood pressure response

Question 7

What is the dose for dopamine infusion for pediatric bradycardia patients?

Answer 7

2-20 mcg/kg/min

Titrate to affect

Question 8

What are probable causes of pediatric bradycardia?

Answer 8

Hypoxia 
Hypothermia
Drug toxicity

Question 9

Do pediatric bradycardia secondary to hypoxia typically respond to external pacing?

Answer 9

No

Question 10

Where should the pads be Placed when attempting external pacing?

Answer 10

Anterior/posterior is preferred, but Antero lateral is acceptable as long as the pads do not overlap.

Question 11

Should EKG electrodes be in contact with pacing electrodes?

Answer 11

No

Question 12

At what weight and under should pediatric pacing pads be used?

Answer 12

33 lbs