ValleyProtocolBook

The Valley Hospital Emergency Services

23

Standing Orders / Communications Failure Orders

Communications Failure Orders pediatric tachycardia

(a) The following Communications Failure orders are authorized in the event that a patient presents with a narrow complex tachycardia:

a. If patient is stable, proceed with treatment as listed above in 8.41-8.17 part (a).

b. If there is any evidence of Wolff-Parkinson-White, administer Amiodarone 5mg/kg up to 150mg via vascular access over 20 minutes.

c. If the patient is unstable and the rhythm has not converted with the above treatment and the patient is conscious, administer Midazolam 0.05 mg/kg to a maximum of 10 mg/kg via vascular access.

d. If the patient has been sedated or is unconscious, provide synchronized cardioversion at 2 J/kg;

i. If there is no response, administer synchronized cardioversion at 4 J/kg

ii. If there is no response, administer synchronized cardioversion at 4 J/kg

e. If the patient still fails to respond, Administer Amiodarone 5 mg/kg up to 150mg via vascular access over 20 minutes.

(b) The following standing orders are authorized in the event that a patient presents with wide complex tachycardia :

a. If the patient is stable, administer Amiodarone 5 mg/kg up to 150 mg via vascular access over 20 minutes.

b. If the patient is unstable and the patient is conscious administer Midazolam 0.05 mg/kg to a maximum of 10 mg/kg via vascular access.

c. If the patient has been sedated or is unconscious, provide synchronized cardioversion at 2 J/kg;

i. If there is no response, administer synchronized cardioversion at 4 J/kg

ii. If there is no response, administer synchronized cardioversion at 4 J/kg