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Medications for Pediatric Resuscitation

MedicationDoseRemarks
Adenosine0.1 mg/kg (max 6 mg)

Second dose: 0.2 mg/kg (max 12 mg)
Monitor ECG

Rapid IV/IO bolus with flush
Amiodarone5 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)
Atropine0.02 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
Epinephrine0.01 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
Glucose0.5-1 g/kg IV/IONewborn: 5-10 mL/kg D10W

Infants and children: 2-4 mL/kg D25W

Adolescents: 1-2 mL/kg D50W
LidocaineBolus: 1 mg/kg IV/IO

Infusion: 20-50 mcg/kg/minute
Magnesium Sulfate25-50 mg/kg IV/IO over 10-20 minutes, faster in torsades de pointes

Maximum dose 2 g
NaloxoneFull 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)
Procainamide15 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 bicarbonate1 mEq/kg per dose IV/IO slowlyAfter 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