Pediatric :

Traumatic Cardiac Arrest

 

History:

 

  • Past medical history
  • Medications
  • End stage renal disease
  • Estimated downtime
  • Suspected hypothermia
  • Suspected overdose
  • DNR form

 

Significant Findings:

 

  • Unresponsive
  • Pulseless
  • Apneic
  • No electrical activity on EKG
  • V-fib/V-tach
  • No auscultated heart tones

 

 Criteria for Death/DNR ?

 

• Yes

 

Consider withholding resuscitation if:

 

    • No pulse and asystole or
    • IInjuries incompatible with life

 

 

 

    • Contact Coroner

 

Criteria for Death/DNR ?

 

• No

 

 

 

    • IImmediate continuous compressions
    • Rapid Transport

 

 

 

    • Cardiac monitor/AED

 

 

 

    • Initiate IV/IO

 

 

 

    • Place advanced airway and provide 8-10 breaths per minute

 

 

 

    • Treat correctable causes early
    • Attach resQpod

 

 

 

 

V-fib/pulseless V-tach ?

 

  • Yes

 

 

 

    • Defibrillate 2 joules/kg; all subsequent shocks at 4 joules/kg

 

 

 

 

 

 

 

 

 

 

    • Place 2nd IV/IO when feasible

 

PEA ?

 

  • Yes

 

 

 

 

 

 

 

Return of spontaneous circulation ?

 

  • Yes

 

    • Notify receiving facility or contact Medical Control

 

PEARLS:

 

  • Hangings are not considered trauma. See appropriate medical protocol.
  • Always confirm asystole in more than one lead.
  • Assign a team resuscitation leader and utilize checklist.
  • Place monitor in paddles mode with metronome on.
  • Reassess and document endotracheal tube placement and EtCO2 frequently, after every move, and at transfer of care.
  • Upload call summary to "QI" upon completion of call.
  • Coroner Notification for High Morbidity Cases
    • In cases in which EMS personnel believe that patient death may be imminent as a result of unnatural causes, the Coroner's Office shall be notified. This notification should be accomplished as soon as reasonably possible. It is the responsibility of the EMS Paramedic to communicate the patient condition with RTS to the EMS Communications Center in order that the Communication Center Staff can notify the On-Duty Coroner.

NRP

National Registry Paramedic

NREMR

National Registry Emergency Medical Responder

NREMT

National Registry Emergency Medical Technician

NREMT-I

National Registry EMT-Intermediate

NRP

National Registry Paramedic

NREMT

National Registry Emergency Medical Technician

NRP

National Registry Paramedic

NRP

National Registry Paramedic

NREMT-I

National Registry EMT-Intermediate

NRP

National Registry Paramedic

NREMT-I

National Registry EMT-Intermediate

NRP

National Registry Paramedic

NREMT-I

National Registry EMT-Intermediate