Society for Pediatric Pain Medicine
Better Care for Children in Pain

The Society for Pediatric Pain Medicine (SPPM) aims to advance the quality of anesthesia care and the alleviation of pain-related conditions in children.

Society for Pediatric
Pain Medicine

Better Care for Children in Pain

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Question of the Month – July 2018

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