PALS Medications for Cardiac Arrest and Symptomatic ...

1 pals Medications for Cardiac Arrest and Symptomatic Arrhythmias DRUG DOSAGE (PEDIATRIC) REMARKS. mg/kg IV/IO;. Adenosine Rapid IV/IO bolus (max single dose 6 mg). Rapid Flush to central circulation Second dose: mg/kg; Monitor ECG during dose. (maximum single dose: 12 mg). Amiodarone for pulseless VF/VT 5 mg/kg IV/IO; (can repeat 5mg/kg Rapid IV bolus bolus to a total 15mg/kg per 24 hr.). Maximum single dose 300 mg Amiodarone for perfusing Loading dose: 5 mg/kg IV/IO IV over 20 to 60 minutes SVT' or VT Maximum total dose: 15 mg/kg per Routine use in combination with drugs day prolonging QT intervals is not recommended.

2 Hypotension is most frequent side effect. Atropine sulfate* mg/kg IV/IO; May give IV, IO or ET. (minimum dose: mg) Tachycardia and pupil dilation may occur Maximum single dose: but not fixed dilated pupils. -Child: mg -Adolescent: mg Maximum total dose: -Child: mg -Adolescent: 3 mg . Calcium chloride 10%=100 mg/mL 20 mg/kg ( mL/kg) IV/IO Give slow IV push for hypocalcemia, ( mg/mL elemental Ca) hypermagnesemia, calcium channel blocker toxicity, preferably via central vein, Monitor heart rate; bradycardia may occur.

3 Calcium Gluconate 60-100 mg/kg ( mL/kg) IV/IO Give slow IV push to hypocalcemia, 10%=100 mg/mL hypermagnesemia, calcium channel blocker (9 mg/mL elemental Ca) toxicity, preferably via central vein. Epinephrine* IV/IO: mg/kg (1:10,000) or Symptomatic bradycardia mL/kg (1:10,000) Tachyarrhythmia's, hypertension may occur. Cardiac Arrest Repeat standard dose q 3-5 min with IV/IO. ET: mg/kg (1:10,000) or May administer high dose via ET tube until mL/kg (1:1,000) IV/IO established. Then begin with first IV. dose. Administer epinephrine every 3 to 5.

4 Minutes in Arrest Glucose (10% or 25% or 50%) IV/IO: g/kg For suspected hypoglycemia; avoid 1-2 mL/kg 50% hyperglycemia. 2-4 mL/kg 25%. 5-10 mL/kg 10%. Lidocaine* IV/IO/ET: 1 mg/kg Rapid bolus Lidocaine infusion IV/IO: 20-50 g/kg per minute Consider a second bolus of mg/kg if (start after a bolus) maintenance infusion is delayed >15. minutes. Magnesium Sulfate (500 mg/mL) Torsades de Point (pulseless) 10 to 20 minute IV infusion for torsades de point (with pulse) or 15 to 30 minute slow IV/IO: 25-50 mg/kg bolus infusion suspected hypomagnesemia, status (maximum dose: 2 g) asthmaticus.

5 Procainamide for perfusing Loading dose: 15 mg/kg IV/IO Infusion over 30 to 60 minutes; routine use tachycardia's (100 mg/mL and 500 in combination with drugs prolonging QT. mg/mL) interval is not recommended. Pronestyl Sodium bicarbonate IV/IO: 1 mEq/kg per dose Infuse slowly and only if ventilation is (1 mEq/mL and mEq/mL) adequate. IV = intravenous IO = Intraosseous ET = endotracheal *For endotracheal administration use higher dose (2 to 10 time the IV dose); dilute medication with normal saline to a volume of 3 to 5.

6 ML and follow with several positive-pressure ventilations.