Medications for Pediatric Resuscitation

Medication Dose Remarks

0.1 mg/kg (max 6 mg)

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

  • Monitor ECG
  • Rapid IV/IO bolus with flush

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 caution when administering with other drugs that prolong QT (obtain expert consultation)

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

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

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

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


Full Reversal:

<5 y or ≤20 kg: 0.1 mg/kg IV/IO/ETT

≥5y 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)

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.


2015 Handbook Of Emergency Cardiovascular Care For Healthcare Providers

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