TYK105

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A 9-year-old patient with known familial dilated cardiomyopathy is in the PICU receiving a milrinone infusion and awaiting a heart transplant. Suddenly she becomes unresponsive and is found to be pulseless. The following rhythm strip is seen:

TYK105.png

Which of the following is the BEST next step?


a) Epinephrine 1:10,000 dilution, 10mcg/kg IV

b) Synchronized cardioversion at 0.5 J/kg

c) Defibrillation at 2 J/kg

d) Defibrillation at 4 J/kg

e) Synchronized cardioversion at 1 J/kg

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Answer

Answer C.

The immediate treatment for pulseless ventricular fibrillation is defibrillation with an initial 2 J/kg. Importantly, CPR should also be initiated pending availability/arrival of a cardiac defibrillator and should continue until the device is charged and ready to shock.

Notes


This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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