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VF/VT-Pulseless (Shock Advised)

Date Last Search Run: Feb 01, 2022
Table last updated: Nov 27, 2021
Data last added: Apr 27, 2022

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)      
2 (fair evidence exists)    
3 (weak evidence exists)    


Interventions

Antiarrhythmic - Class I (Na+ channel blockers)
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) In-hospital mortality Patient ED-MD Valdes SO., Donoghue AJ., Hoyme DB., et al. Outcomes associated with amiodarone and lidocaine in the treatment of in-hospital pediatric cardiac arrest with pulseless ventricular tachycardia or ventricular fibrillation. Resuscitation 2014; 85(3):381-6. Medline
II Neutral (Yellow) Survival Patient PH-Paramedic Moler FW., Donaldson AE., Meert K., et al. Multicenter cohort study of out-of-hospital pediatric cardiac arrest. Crit Care Med 2011; 39(1):141-9. Medline
III Neutral (Yellow) Survival to hospital admission Patient McBride ME., Marino BS., Webster G., Lopez-Herce J., Ziegler CP., De Caen AR., et al. Amiodarone Versus Lidocaine for Pediatric Cardiac Arrest Due to Ventricular Arrhythmias: A Systematic Review. Pediatric Critical Care Medicine 2017; 18(2):183-9. Medline

Antiarrhythmic - Class III (K+ channel blockers)
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Survival Patient PH-Paramedic Moler FW., Donaldson AE., Meert K., et al. Multicenter cohort study of out-of-hospital pediatric cardiac arrest. Crit Care Med 2011; 39(1):141-9. Medline
II Neutral (Yellow) Functional status Patient OR Valdes SO., Donoghue AJ., Hoyme DB., et al. Outcomes associated with amiodarone and lidocaine in the treatment of in-hospital pediatric cardiac arrest with pulseless ventricular tachycardia or ventricular fibrillation. Resuscitation 2014; 85(3):381-6. Medline
III Supportive (Green) Conversion Patient ED-MD Perry J., Fenrich A., Hulse E., et al. Pediatric use of intravenous amiodarone: Efficacy and safety in critically ill patients from a multicenter protocol. J Am Coll Cardiol 1996; 27:1246-50. Medline
III Supportive (Green) Alleviation of nausea Patient In-Patient Perry J., Knilans T., Marlow D., et al. Intravenous amiodarone for life-threatening tachyarrhythmias in children and young adults. J Am Coll Cardiol 1993; 22:95-8. Medline
III Neutral (Yellow) Survival to hospital admission Patient McBride ME., Marino BS., Webster G., Lopez-Herce J., Ziegler CP., De Caen AR., et al. Amiodarone Versus Lidocaine for Pediatric Cardiac Arrest Due to Ventricular Arrhythmias: A Systematic Review. Pediatric Critical Care Medicine 2017; 18(2):183-9. Medline

Biphasic Defibrillation
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) 30-day neurologically intact survival Patient PH-Paramedic Goto Y, Funada A, Maeda T. Association of subsequent treated shockable rhythm with outcomes after paediatric out-of-hospital cardiac arrests: A nationwide, population-based observational study. Resusc Plus 2021; 8:100181. Medline
III Supportive (Green) Survival Patient PH-Paramedic Gurnett CA., Atkins DL. Successful use of a biphasic waveform automated external defibrillator in a high-risk child. Am J Cardiol 2000; 86(9):1051-3. Medline
III Supportive (Green) Termination of VF Process ED-MD Gutgesell H., Tacker W., Geddes L., et al. Energy doses for ventricular defibrillation of children. Pediatrics 1976; 58:898-901. Medline
III Supportive (Green) Survival from OHCA Patient PH-Paramedic & CCT Kingsley P, Merefield J, Walker RG, Chapman FW, Faulkner M. Out-of-hospital resuscitation of a 3 month old boy presenting with recurrent ventricular fibrillation cardiac arrest: a case report. Scand J Trauma Resusc Emerg Med 2021; 29(1):58. Medline
III Supportive (Green) Survival Patient PH-Paramedic Konig B., Benger J., Goldsworthy L. Automatic external defibrillation in a 6 year old. Arch Dis Child 2005; 90(3):310-1. Medline
III Supportive (Green) ROSC Patient PH-Paramedic Rodriguez-Nunez A., Lopez-Herce J., Garcia C., et al. Pediatric defibrillation after cardiac arrest: Initial response and outcome. Crit Care 2006; 10(4):R113. Medline
III Neutral (Yellow) VF termination Process PH-Paramedic Berg MD., Samson RA., Meyer RJ., Clark LL., Valenzuela TD., Berg RA. Pediatric defibrillation doses often fail to terminate prolonged out-of-hospital ventricular fibrillation in children. Resuscitation 2005; 67(1):63-7. Medline

CPR before defibrillation
Level Direction Primary Outcome Patient/Process Setting Reference

Magnesium Sulfate
Level Direction Primary Outcome Patient/Process Setting Reference


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