Birmingham Children’s Hospital ED Handbook Version 1 (2011)

(1.4) VF & PULSELESS VT

VF or Pulseless VT

DC Shock 4 J/kg SHOCK 1

Resume CPR
Secure airway when able IV/IO access
Secure airway
Once intubated: continuous
chest compressions and
ventilation rate of 10-12 per
minute After 2 mins: assess rhythm
No change in rhythm

DC Shock 4 J/kg SHOCK 2

Resume CPR

After 2 mins: assess rhythm

No change in rhythm

DC Shock 4 J/kg SHOCK 3

* 0.1 ml/kg of 1:10,000 Resume CPR
*
Adrenaline 10 mcg/kg
# #
IV/IO over 3 mins Amiodarone 5 mg/kg

After 2 mins: assess rhythm

No change in rhythm

DC Shock 4 J/kg SHOCK 4

Torsade de Pointes:
Resume CPR
Magnesium Sulphate
25 – 50 mg/kg IV
over 10 – 15 mins
After 2 mins: assess rhythm
(max dose 2 g) No change in rhythm

DC Shock 4 J/kg SHOCK 5

Resume CPR
*
Adrenaline 10 mcg/kg
#
Amiodarone 5 mg/kg

After 2 mins: assess rhythm

No change in rhythm
If defibrillation was
successful but VF/VT recurs,
amiodarone can be repeated SHOCK 6
(unless two doses have DC Shock 4 J/kg
already been injected) and a Resume CPR
continuous infusion started
(initial rate 300 mcg/kg/hr)
After 2 mins: assess rhythm
No change in rhythm

DC Shock 4 J/kg SHOCK 7

Resume CPR
References *
• Resuscitation Council (UK) Guidelines 2010
Adrenaline 10 mcg/kg
• APLS The Practical Approach (5th Edition)