Medications for Pediatric Resuscitation
Medication Dose Remarks
Adenosine 0.1 mg/kg (maximum 6 mg)

Second dose: 0.2 mg/kg (maximum 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 rhythmUse caution when administering with other drugs that prolong QT (obtain expert consultation)
Atropine 0.02 mg/kg IV/IO

0.04–0.06 mg/kg ET*

Repeat once if neededMaximum 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) ET*

Maximum dose 1 mg IV/IO; 2.5 mg ET

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 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)
Procainamide 15 mg/kg IV/IO

Adult Dose: 20 mg/min IV infusion to a 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
Infusion Rate
[weight (kg) X dose (mcg/kg per min) X 60 (min/hour)]
  • IV indicates intravenous; IO, intraosseous; and ET, via endotracheal tube.
  • * Flush with 5 mL of normal saline and follow with 5 ventilations.

Last Updated 2010