Table 1.

Medications for Pediatric Resuscitation

MedicationDoseRemarks
Adenosine0.1 mg/kg (maximum 6 mg) Second dose: 0.2 mg/kg (maximum 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 mgMonitor 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 caution when administering with other drugs that prolong QT (obtain expert consultation)
Atropine0.02 mg/kg IV/IO 0.04–0.06 mg/kg ET* Repeat once if needed Minimum dose: 0.1 mg Maximum single dose: 0.5 mgHigher doses may be used with organophosphate poisoning
Calcium Chloride (10%)20 mg/kg IV/IO (0.2 mL/kg) Maximum single dose 2 gAdminister slowly
Epinephrine0.01 mg/kg (0.1 mL/kg 1:10,000) IV/IO 0.1 mg/kg (0.1 mL/kg 1:1000) ET* Maximum dose 1 mg IV/IO; 2.5 mg ETMay 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 y or ≤20 kg: 0.1 mg/kg IV/IO/ET* ≥5y or >20 kg: 2 mg IV/IO/ET*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/kgMonitor 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 ET, via endotracheal tube.

  • * Flush with 5 mL of normal saline and follow with 5 ventilations.