N.J. Admin. Code § 8:41-8.7

Current through Register Vol. 56, No. 21, November 4, 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;

2. Secure the airway;

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; or

ii. 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; and

11. 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;

2. Secure the airway;

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; or

ii. 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; and

9. Contact the medical command physician.

N.J. Admin. Code § 8:41-8.7