Amiodarone for refractory VF/VT at 5 mg/ktg/dose via IV or IO access.
Other medications for specific special resuscitation circumstances may be appropriate, such as for hyperkalemia: calcium, bicarbonate, glucose, insulin, kayexalate, hyperventilation.
Diagnosis
Establish the diagnosis
Cardiopulmonary arrest in children is usually the end result of respiratory failure and/or shock.
Hypoxia and ischemia lead to hypotension, apnea, and mexico email list bradycardia, with poor perfusion often resulting in PPE (Pulseless Electrical Activity) or asystole.
The patient progresses to unresponsiveness, unrespiratory failure other than an occasional gasp, and unresponsiveness to verbal or physical stimuli. Pulses are difficult to palpate at the carotid, brachial, or femoral centrally, and capillary refill is markedly delayed >3 seconds. Pupils dilate and fixate.
Diagnostic approach
Reversible causes should be sought and treated.
Begin chest compressions, call for help, and quickly determine if there is a shockable rhythm. If a shockable rhythm is not present, continue CPR, order epinephrine, and look for treatable causes such as toxins (antidotes), electrolyte imbalances, physical impediments to cardiac resuscitation (pneumothorax, pericardial tamponade), hypothermia, or pulmonary embolism.
