Medications for Pediatric Resuscitation
| Medication | Dose | Remarks |
| Adenosine | 0.1 mg/kg (max 6 mg)
Second dose: 0.2 mg/kg (max 12 mg) | Monitor ECG Rapid IV/IO bolus with flush |
| Amiodarone | 5 mg/kg IV/IO; may repeat twice up to 15 mg/kg Maximum single dose 300 mg | Monitor ECG and blood pressure Adjust administration rate to urgency (IV push during cardiac arrest, more slowly - over 20-60 minutes with perfusing rhythm) Expert consultation strongly recommended prior to use when patient has a perfusing rhythm Use cation when administering with other drugs that prolong QT (obtain expert consultation) |
| Atropine | 0.02 mg/kg IV/IO 0.04-0.06 mg/kg ETT* Repeat once if needed Maximum single dose: 0.5 mg | Higher doses may be used with organophosphate poisoning |
| Calcium Chloride (10%) | 20 mg/kg IV/IO (0.2 mL/kg) Maximum single dose 2 g | Administer slowly |
| Epinephrine | 0.01 mg/kg (0.1 ml/kg 1:10 000) IV/IO 0.1 mg/kg (0.1 mL/kg 1:1000) ETT* Maximum dose 1 mg IV/IO; 2.5 mg ETT* | May repeat every 3-5 minutes |
| Glucose | 0.5-1 g/kg IV/IO | Newborn: 5-10 mL/kg D10W Infants and children: 2-4 mL/kg D25W Adolescents: 1-2 mL/kg D50W |
| Lidocaine | Bolus: 1 mg/kg IV/IO Infusion: 20-50 mcg/kg/minute | |
| Magnesium Sulfate | 25-50 mg/kg IV/IO over 10-20 minutes, faster in torsades de pointes Maximum dose 2 g | |
| Naloxone | Full reversal: <5 years or ≤20 kg: 0.1 mg/kg IV/IO/ETT ≥5 years or >20 kg: 2 mg IV/IO/ETT* | Use lower doses to reverse respiratory depression associated with therapeutic opioid use (1-5 mcg/kg titrate to effect) |
| Procainamide | 15 mg/kg IV/IO Adult dose: 20 mg/min IV infusion to total maximum dose of 17 mg/kg | Monitor ECG and blood pressure Give slowly - over 30-60 minutes Use caution when administering with other drugs that prolong QT (obtain expert consultation) |
| Sodium bicarbonate | 1 mEq/kg per dose IV/IO slowly | After adequate ventilation |
IV indicates intravenous; IO, intraosseous; and ETT, via endotracheal tube.
*Flush with 5 mL of normal saline and follow with 5 ventilations.
Citations/References:
2015 Handbook Of Emergency Cardiovascular Care For Healthcare Providers