PGE1 0.1mcg/kg/min IV/IO
Side Effects:
Apnea (intubate)
Hypotension
Bradycardia
Flushing
NS 10cc/kg
Dobutamine
Side Effects:
Apnea (intubate)
Hypotension
Bradycardia
Flushing
Apnea (intubate)
Hypotension
Bradycardia
Flushing
Hypotension
Bradycardia
Flushing
Knee chest position
Increased venous return to heart, increased SVR (decreased R>L shunting)
O2
Morphine or NS to increase preload
Sodium bicarbonate 2mEq/kg IV bolus (promotes vasodilation)
Propranolol 0.2mg/kg IV (relieves infundibular spasm)
Phenylephrine 2-10mcg/kg/min to increased SVR
Increased venous return to heart, increased SVR (decreased R>L shunting)
O2 (give only if SpO2 <95%)
Furosemide 1-2mg/kg IV
Dopamine 5-10mcg/kg/min
Dobutamine 5-10mcg/kg/min
Blalock-Taussig shunt should maintain flow murmur
Loss of flow murmur alongside profound hypoxia relative to baseline saturations should prompt consideration for shunt obstruction
Definitive treatment is surgical, but systemic recombinant tPA may be considered as salvage intervention when other options are not readily available
Heparin bolus 50-100 u/kg
Notify cardiology, CT surgeon, ECMO
0.01 mg/kg bolus r-tPA, then 0.03 - 0.06 mg/kg/hr
Heparin bolus 50-100 u/kg
Notify cardiology, CT surgeon, ECMO
0.01 mg/kg bolus r-tPA, then 0.03 - 0.06 mg/kg/hr
Congenital heart disease
THE MISFITS [2]
Central nervous system tumor 
Trauma
Central nervous system tumor
Heart
CVC catheter problems
Trauma 