Pediatric PEA part 2

Pediatric PEA Rhythms

Idioventricular rhythm

Sinus bradycardia

Sinus tachycardia with inverted T waves

Agonal Rhythm

PEA mnemonic:  Keep them ALIVE

Assess ABCs

Listen for pulse using doppler

Initiate CPR

Vasoconstrictors

Evaluate reversable causes

Assess ABCs- Primary Survey

·         Assess responsiveness and pulse

·         Active EMS system

·         Call for defibrillator/monitor

Note:  If a rhythm is present on the monitor but the pulse is absent (eg,PEA), CPR should be started immediately, beginning with chest compressions, and should continue for 2 minutes before the rhythm check is repeated.

Listen for Pulse Using Doppler

·         A doppler will help distinguish between a pulseless state and profoundly weak cardiac contractions with a low cardiac output (pseudo-PEA).

·         True PEA:  no pulse and no perfusion

·         Pseudo-PEA: weak pulse detected by doppler or echocardiography and severely compromised perfusion

Initiate CPR

·         Adequate compression rate (at least 100 compressions/min)

·         Adequate compression depth (at least one third of the AP diameter of the chest or approximately    1 1⁄2 inches [4 cm] in infants and approximately 2inches [5 cm] in children)

·         Allowing complete recoil of the chest after each compression

·         Minimizing interruptions in compression

·         Avoiding excessive ventilation