0071643192.pdf

DOSE

■ 0.5–1 g/kg IV/IO (2–4 mL/kg D 25 Win pediatrics, D 10 W in neonates)

INTERVENTIONSTHATARENOTHELPFUL

The following interventions have not been shown to be helpful and are there-
forenotrecommended in the treatment of cardiac arrest:

■ Norepinephrine
■ Procainamide
■ Cardiac pacing in the treatment of asystole

Permanent Pacemakers

Generally agreed upon indications (class I) for permanentpacemaker place-
ment include:

■ High-grade AV block (third-degree and second-degree type II) with
■ Asystole> 3 seconds
■ Escape rate < 40 bpm
■ Following ablation or heart surgery
■ Neuromuscular disease
■ Any symptomatic second- or third-degree AV block
■ Second-degree AV block with wide QRS (indicating BBB)
■ Symptomatic sinus node dysfunction or chronotropic incompetence

Individual pacer function is determined by a 3–5 letter code, employed by the
North American Society of Pacing and Eletrophysiology (see Table 1.11).

RESUSCITATION

Cardiac pacing is not

recommended in the

treatment of asystole.

TABLE 1.11. Interpretation of Pacemaker Codes

1st letter 2nd letter 3rd letter 4th letter 5th letter

CHAMBER CHAMBER RESPONSE TO PROGRAMMABLE ANTITACHYCARDIA

PACED SENSED SENSING FUNCTIONS FEATURES

V = ventricle V= ventricle T= triggered P= programmable rate, P= antitachycardia

output, or both pacing

A= atrium A= atrium I= inhibited M= multiprogrammability S= shock

of rate, output, sensitivity,

etc.

D= dual D= dual D= dual C= communication function D= dual

(telemetry)

O= none O= none O= none R= rate modulation O= none

O= none

VVI pacemaker = ventricular

paced, ventricular sensed,

inhibited (response to

sensing).