PALS Protocol:

Ventricular Fibrillation or Pulseless Tachycardia

"Shock, shock, shock, everybody shock, little shock, big shock, everybody, shock, shock"

1.   Asynchronous shock, 2 J/kg
2.   Asynchronous shock, 4 J/kg
3.   Asynchronous shock, 4 J/kg
4.   CPR, Intubate
5.   IV access
6.   Epinephrine 0.01 mg/kg of 1:10,000
7.   Asynchronous shock, 4 J/kg
8.   Lidocaine 1 mg/kg
9.   Asynchronous shock, 4 J/kg
10.  Bretylium 5 mg/kg
11.  Asynchronous shock, 4 J/kg
12.  Bretylium 10 mg/kg
13.  Asynchronous shock, 4 J/kg
14.  Repeat Lidocaine, Epinephrine, or Bretylium
15.  If no response with 4 J/kg, increase to 8 J/kg
 
Emergency Pediatrics
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Last modification: September 27, 1998