Pediatric PVST

P604

• Obtain 12 lead ECG

If STABLE patient:

• Vagal maneuvers
• Contact medical control
• Adenosine 0.1 mg/kg IV rapid push (maximum first dose 6 mg); may repeat with dose doubled (maximum second dose 12 mg)
• Only on the conscious patient and the order of a medical control physician, administer midazolam 0.1 mg/kg (max 5 mg) IV/IO or other medications as directed by medical control) and deliver synchronized cardioversion 0.5 J/kg
• If unsuccessful, repeat synchronized cardioversion at 1 J/kg
• If unsuccessful, repeat synchronized cardioversion at 2 J/kg
• Round the joules up

If UNSTABLE patient:

• Contact medical control
• Midazolam 0.1 mg/kg (max 5 mg) IV/IO
• Synchronized cardioversion 0.5 J/kg.
• If unsuccessful, repeat synchronized cardioversion at 1 J/kg
• If unsuccessful, repeat synchronized cardioversion at 2 J/kg
• Round the joules up