Current through Register Vol. 56, No. 23, December 2, 2024
Section 8:41-8.7 - Standing orders for pediatric cardiac arrest(a) The following standing orders are authorized in the event that a pediatric patient presents with ventricular fibrillation and/or pulseless ventricular tachycardia: 1. Determine pulselessness and begin CPR;3. Hyperventilate with 100 percent oxygen;4. Maintain normal body temperature;5. Defibrillate at 2 J/kg or equivalent biphasic;6. If no change in rhythm, defibrillate at 4 J/kg or equivalent biphasic;7. If no change in rhythm, defibrillate at 4 J/kg or equivalent biphasic;8. Establish IV/IO access with normal saline solution at a KVO rate;9. Administer epinephrine: i. 0.01 mg/kg (0.1 mL/kg) of a 1:10,000 solution via IV/IO; orii. 0.1 mg/kg (0.1 mL/kg) of a 1:1,000 solution via ET (diluted with normal saline to 5 ml);10. If no change in rhythm, defibrillate at 4 J/kg or equivalent biphasic; and11. Contact the medical command physician.(b) The following standing orders are authorized in the event that a patient presents with asystole and/or pulseless electrical activity (PEA): 1. Determine pulselessness and begin CPR;3. Hyperventilate with 100 percent oxygen;4. Maintain normal body temperature;5. If asystole, confirm cardiac rhythm in more than one lead. If PEA, identify causes;6. Establish IV/IO access with normal saline solution at a KVO rate;7. Administer epinephrine: i. 0.01 mg/kg (0.1 mL/kg) of a 1:10,000 solution via IV/IO; orii. 0.1 mg/kg (0.1 mL/kg) of a 1:1,000 solution via ET (diluted with normal saline to 5 ml);8. Administer a rapid fluid bolus of 20 ml/kg of normal saline via IV/IO; and9. Contact the medical command physician. N.J. Admin. Code § 8:41-8.7