TABLE 1

Medications for Pediatric Resuscitation and Arrhythmias

MedicationDoseRemarks
Adenosine0.1 mg/kg (maximum 6 mg)Monitor ECG
Repeat: 0.2 mg/kg (maximum 12 mg)Rapid IV/IO bolus
Amiodarone5 mg/kg IV/IO; repeat up to 15 mg/kg (maximum: 300 mg)Monitor ECG and blood pressure
Adjust administration rate to urgency (give more slowly when perfusing rhythm present)
Use caution when administering with other drugs that prolong QT (consider expert consultation)
Atropine0.02 mg/kg IV/IOHigher doses may be used with organophosphate poisoning
0.03 mg/kg ETa
Repeat once if needed
Minimum dose: 0.1 mg
Maximum single dose:
    Child 0.5 mg
    Adolescent 1 mg
Calcium chloride (10%)20 mg/kg IV/IO (0.2 mL/kg)Slowly
Adult dose: 5–10 mL
Epinephrine0.01 mg/kg (0.1 mL/kg 1:10 000) IV/IOMay repeat every 3–5 min
0.1 mg/kg (0.1 mL/kg 1:1000) ETa
Maximum dose: 1 mg IV/IO; 10 mg ET
Glucose0.5–1 g/kg IV/IOD10W: 5–10 mL/kg
D25W: 2–4 mL/kg
D50W: 1–2 mL/kg
LidocaineBolus: 1 mg/kg IV/IO
Maximum dose: 100 mg
Infusion: 20–50 μg/kg per min
ETa: 2–3 mg
Magnesium sulfate25–50 mg/kg IV/IO over 10–20 min; faster in torsades
Maximum dose: 2g
Naloxone<5 y or ≤20 kg: 0.1 mg/kg IV/IO/ETaUse lower doses to reverse respiratory depression associated with therapeutic opioid use (1–15 μg/kg)
≥5 y or >20 kg: 2 mg IV/IO/ET
Procainamide15 mg/kg IV/IO over 30–60 minMonitor ECG and blood pressure
Adult dose: 20 mg/min IV infusion up to total maximum dose 17 mg/kgUse caution when administering with other drugs that prolong QT (consider expert consultation)
Sodium bicarbonate1 mEq/kg per dose IV/IO slowlyAfter adequate ventilation
  • a Flush with 5 mL of normal saline and follow with 5 ventilations. ET indicates via endotracheal tube.