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    ACLS-Pediatric Wide Complex Tachycardia: Sample Medical Guidelines

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    FebrialitaFatoni
    This document provides medical guidelines for paramedics responding to pediatric patients experiencing wide complex tachycardia. It outlines priorities for assessment including vital signs and symptoms. It describes examination findings to note and goals of therapy. Treatment protocols are provided for different certification levels, including establishing an airway, oxygen therapy, IV fluids, cardiac monitoring, synchronized cardioversion if unstable, and contacting medical control for consultation or additional treatment. The overarching guidelines are to assume wide complex rhythms indicate ventricular tachycardia, treat life-threatening presentations urgently while avoiding direct rhythm treatment if stable.

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    ACLS-Pediatric Wide Complex Tachycardia: Sample Medical Guidelines

    Uploaded by

    FebrialitaFatoni
    25 views2 pages
    This document provides medical guidelines for paramedics responding to pediatric patients experiencing wide complex tachycardia. It outlines priorities for assessment including vital signs and symptoms. It describes examination findings to note and goals of therapy. Treatment protocols are provided for different certification levels, including establishing an airway, oxygen therapy, IV fluids, cardiac monitoring, synchronized cardioversion if unstable, and contacting medical control for consultation or additional treatment. The overarching guidelines are to assume wide complex rhythms indicate ventricular tachycardia, treat life-threatening presentations urgently while avoiding direct rhythm treatment if stable.

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    aclspediatricwide-complextachycardia

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    This document provides medical guidelines for paramedics responding to pediatric patients experiencing wide complex tachycardia. It outlines priorities for assessment including vital signs and symptoms. It describes examination findings to note and goals of therapy. Treatment protocols are provided for different certification levels, including establishing an airway, oxygen therapy, IV fluids, cardiac monitoring, synchronized cardioversion if unstable, and contacting medical control for consultation or additional treatment. The overarching guidelines are to assume wide complex rhythms indicate ventricular tachycardia, treat life-threatening presentations urgently while avoiding direct rhythm treatment if stable.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    25 views2 pages

    ACLS-Pediatric Wide Complex Tachycardia: Sample Medical Guidelines

    Uploaded by

    FebrialitaFatoni
    This document provides medical guidelines for paramedics responding to pediatric patients experiencing wide complex tachycardia. It outlines priorities for assessment including vital signs and symptoms. It describes examination findings to note and goals of therapy. Treatment protocols are provided for different certification levels, including establishing an airway, oxygen therapy, IV fluids, cardiac monitoring, synchronized cardioversion if unstable, and contacting medical control for consultation or additional treatment. The overarching guidelines are to assume wide complex rhythms indicate ventricular tachycardia, treat life-threatening presentations urgently while avoiding direct rhythm treatment if stable.

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    © All Rights Reserved
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    Download as doc, pdf, or txt
    of 2

    State of Wisconsin

    Emergency Medical Services


    Sample Medical Guidelines
    ACLS-Pediatric Wide Complex Tachycardia
    Note:
    Wide complex rhythms have a QRS duration > 0.09 sec
    Although some wide complex tachycardias develop from supraventricular tachycardias,
    prehospital providers should always assume that wide complex rhythms are ventricular
    tachycardia (VT), particularly if the patient is unstable.
    Because all arrhythmia therapies have the potential for serious adverse effects, children who are
    hemodynamically stable should not have rhythm directly treated
    Priorities Assessment Findings
    Chief Complaint Palpitations, fast heart rate, shortness of breath, chest pain, weakness, syncope,
    cardiac arrest/pulseless non-breather
    OPQRST Onset and duration, precipitating factors and circumstances, associated
    symptoms, stroke symptoms, nausea vomiting
    Associated Symptoms/ Chest pain, shortness of breath, weakness, anxiety, leg swelling
    Pertinent Negatives
    SAMPLE Previous history, history of thyroid disease, CAD, Cardiac Medications
    Obtain history of previous episodes of tachycardia, including diagnoses if
    known. Pay particular attention to whether there is an underlying history
    of pre-excitation, including the Wolff-Parkinson-White (WPW) Syndrome.
    Obtain history of what medications have been used to treat previous
    arrhythmias, if known.
    Obtain history of any previous complications from previous arrhythmia
    treatments, if known.
    Obtain history of the duration of the current episode of tachycardia, if
    known.
    Initial Exam Check ABCs and correct any immediate life threatening problems.
    Detailed Focused Exam General Appearance: ill-appearing?
    Skin: Cool, pale diaphoretic
    Neck: JVD?
    Chest: Labored breathing
    Lungs: Wheezes, rales, rhonchi? Decreased breath sounds?
    Heart: Regular, rate fast or slow, murmur
    Legs: Edema
    Neuro: ALOC?
    Goals of Therapy Decrease rate, improve perfusion, treat chest pain, treat CHF
    Monitoring BP, HR, RR, EKG, SpO2.

    Updated 1/2011
    Origination 09/2008 Page 1
    EMERGENCY MEDICAL RESPONDER (EMR) /
    EMERGENCY MEDICAL TECHNICIAN (EMT)
    Routine Medical Care
    Ensure an adequate airway.
    Titrate oxygen therapy to the lowest level required to maintain an oxygen saturation greater than
    93%
    If the patient is having difficulty breathing allow them to find a position of comfort
    If the patient becomes unresponsive, pulseless and non-breathing, follow the Pediatric Cardiac
    Arrest Guidelines.
    If the patient also experiences signs of respiratory distress or inadequate breathing, follow the
    Pediatric Respiratory Distress Guidelines

    ADVANCED EMT (AEMT)


    IV/IO NS @ TKO, if approved.
    If SPB < 100 mmHg give 20 ml/kg fluid bolus, then reassess

    Contact Medical Control for the following:


    Additional fluid orders

    INTERMEDIATE / PARAMEDIC
    Monitor the heart rhythm
    o Identify a wide complex rhythm (QRS > 0.09 sec)
    If the patient has no palpable pulses, proceed according to the Pediatric Cardiac Arrest Guidelines
    Evaluate the perfusion status
    o If the patient has good perfusion prepare for transport

    Contact Medical Control for the following:


    Consultation about rhythm analysis
    If the patient is has signs of poor perfusion
    o Prepare to perform synchronized cardioversion
    o Perform first synchronized cardioversion @ 0.5 1 J/kg
    o If unsuccessful, increase to 2 J/kg for the second shock
    o If unsuccessful, consider Amiodarone 5mg/kg over 20-60 min or Lidocaine 1 mg/kg
    IV/IO.
    If the patient maintains adequate perfusion, further treatment can be safely delayed until the patient
    arrives in the emergency department.

    Updated 1/2011
    Origination 09/2008 Page 2

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