Question of the Month - July 2018 - Society for Pediatric Pain Medicine

VentricularTachycardia in a Ten-month-old?
Jennifer Zieg MD, University of Colorado, Children’s Hospital Colorado

A 9 kg 10-month-old is undergoing thoracotomy for unilateral congenital cystic adenomatoid malformation (CCAM) resection. He was born at full term, and has had no other health problems. The patient has a thoracic epidural in place that seems to have been working well. A new nurse enters her shift and accidentally gives a 10ml bolus through the epidural. The patient develops ventricular tachycardia and hypotension. What is the MOST appropriate next step?

1. Administer a dose of epinephrine

2. Start CPR and call for the defibrillator

3. Administer a dose of intralipid

4. Ask the surgeons to do internal cardiac massage

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Question of the Month – July 2018

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