Pediatric Pulseless Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF)

Cardiac Arrest in Infants and Children

·         Does not usually result from a primary cardiac cause

·         Terminal result of progressive respiratory failure or shock

·         Asphyxia begins

·         Period of systemic hypoxemia, hypercapnia, and acidosis

·         Progresses to bradycardia and hypotension

·         Culminates with cardiac arrest

Pulseless Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF)

·         Initial cardiac rhythm in about  5% to 15% of pediatric in-hospital and out-of-hospital cardiac arrests

·         Reported in up to 27% of pediatric in-hospital arrests at some point during the resuscitation

·         The incidence of VF/pulseless VT cardiac arrest rises with age

Ventricular Tachycardia

·         Rate: The ventricular rate is 120 - 250

·         Rhythm: The rhythm is usually regular

·         P Wave: Not usually visible

·         PRI: No P wave and hence, no PRI

·         QRS: The QRS is wide and bizarre, usually 0.09 or greater

·         S-T Segment: No usually discernible

·         T Waves: No usually discernible

Ventricular Tachycardia

Polymorphic Ventricular Tachycardia (Torsades de Pointe)

·         Rate: The ventricular rate is 150 - 250

·         Rhythm: The rhythm is usually irregular.

·         P Wave: Not usually visible

·         PRI: No P wave and hence, no PRI

·         QRS: The QRS is wide and bizarre and of varying amplitude, usually 0.09 or greater. Axis changes from positive to negative

·         S-T Segment: Not discernible

·         T Waves: Not discernible

Polymorphic Ventricular Tachycardia

Ventricular Fibrillation

·         Rate: None

·         Rhythm: The waveform is totally chaotic

·         P Wave: None

·         PRI: No PRI

·         QRS: None

·         S-T Segment: None

·         T Waves: None

Ventricular Fibrillation