Verse 1 Tone drops at the station, pediatric call, Tiny chest rising, heart racing through it all. I’m thinking history as I climb in the rig— Past medical notes, what meds does the kid? Aminophylline, diet pills in the home, Thyroid supplements, decongestants, digoxin alone. Nicotine, cocaine — toxic exposure risk, Congenital heart disease can’t be missed. Respiratory distress, syncope in the past, Near-fainting episodes — this heart’s beating fast. Pre-Chorus Check the monitor, get the rhythm tight, Narrow complex under point zero nine — that’s right. Cardiac monitor, pads anterior-posterior, IV or IO — we’re ready for more. Chorus Pediatric tachycardia — narrow and quick, Child over 180, infant over 220 — that’s the trick. Pale or cyanotic, sweaty and weak, Tachypnea, vomiting — perfusion’s bleak. Hypotension, altered mental state, Pulmonary congestion — we can’t wait. Is it stable, or is it not? Treat the cause — that’s the plot. Verse 2 I assess the child in clinical view, Not just the rate — what’s the body trying to do? Differential running through my mind: Fever, sepsis, hypoxia to find. Hypovolemia, anemia low, Electrolytes off can steal the show. Anxiety, pain, emotional stress, Hypoglycemia — we must assess. Hypo or hyperthermia’s flame, Pulmonary embolus, trauma in play. Tension pneumothorax can mimic the fight — Underlying cause is our guiding light. Pre-Chorus If pulseless — no time to debate, Pediatric arrest protocol — activate. But if pulses beat and rhythm’s seen, We sort sinus from SVT on the screen. Chorus Sinus tach — P waves show, R-R variable, not too slow. Usually under the age-based line, Treat the fever, pain, or fluid time. But SVT — abrupt and fast, No clear P waves, rhythm locked in blast. Over 180 in kids we see, Over 220 in infancy. Bridge Stable or unstable — that’s the key, Shock or AMS means urgency. Poor perfusion, sudden collapse, This rhythm can’t be left to lapse. We run vagal maneuvers first in line, Breath hold, birthday candles — try to align. Ice to the infant’s face with care, Keep the airway open — always aware. Continuous monitoring, pulse ox on tight, Watch for hypotension in every light. If SVT won’t convert with a push, Adenosine rapid — give it a rush. Point one milligram per kilo IV/IO, Max twelve milligrams — go with the flow. If that fails, then escalate dose, Point two per kilo — that’s how we close. If unstable and rhythm won’t cease, Synchronized cardioversion brings relief. One joule per kilo to start the plan, Then two, maybe four — follow protocol, stand. Adult max if weight demands, Pads placed anterior-posterior hands. Consider sedation for the shock we give — Midazolam helps them tolerate and live. Mental status, skin, neck, lungs, heart, Abdomen, neuro — we do our part. Final Chorus Assess the tachycardia in context wide, Find the cause — don’t let it hide. 12-lead when stable, not in the storm, Single lead monitor keeps us informed. Differentiate rhythm — that’s the goal, Stable or unstable defines the role. At any time if pulses cease, Switch to arrest — and seek release. Outro From the rig to the bedside light, We treat the child with skill and sight. Narrow complex — fast but clear, Find the cause and bring them near. In every beat, our mission stands: Protect their heart with steady hands.
