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The Valley Hospital Emergency Services
Standing Orders / Communications Failure Orders
23
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