2006
PALS Algorithms
|
Medication
|
Dose
|
Remarks
|
| Adenosine | 0.1 mg/kg (maximum 6 mg) | Monitor ECG |
| Repeat: 0.2 mg/kg (maximum 12 mg) | Rapid IV/IO bolus | |
| Amiodarone | 5 mg/kg IV/IO; repeat up to 15 mg/kg | Monitor ECG and blood pressure |
| Maximum: 300 mg | 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) | ||
| Atropine | 0.02
mg/kg IV/IO 0.03 mg/kg ET* |
Higher doses may be used with organophosphate poisoning |
| 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 | ||
| Epinephrine | 0.01 mg/kg (0.1 mL/kg 1:10 000) IV/IO | May repeat q 3-5 min |
| 0.1 mg/kg (0.1 mL/kg 1:1000) ET* | ||
| Maximum dose: 1 mg IV/IO; 10 mg ET | ||
| Glucose | 0.5-1 g/kg IV/IO | D10W: 5-10 mL/kg |
| D25W: 2-4 mL/kg | ||
| D50W: 1-2 mL/kg | ||
| Lidocaine | Bolus: 1 mg/kg IV/IO | |
| Maximum dose: 100 mg | ||
| Infusion: 20-50 µg/kg per minute | ||
| ET*: 2-3 mg | ||
| Magnesium sulfate | 25-50 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/ET* 5 y or >20 kg: 2 mg IV/IO/ET* |
Use lower doses to reverse respiratory depression associated with therapeutic opioid use (1-15 µg/kg) |
| Procainamide | 15 mg/kg IV/IO over 30-60 | Monitor ECG and blood pressure |
| Adult dose: 20 mg/min IV infusion up to total maximum dose 17 mg/kg | Use caution when administering with other drugs that prolong QT (consider expert consultation) | |
| Sodium bicarbonate | 1 mEq/kg per dose IV/IO slowly | After adequate ventilation |
Medications
to Maintain Cardiac Output and for Postresuscitation Stabilization
|
Medication
|
Dose
Range
|
Comment
|
| Inamrinone | 0.75-1 mg/kg IV/IO over 5 minutes; may repeat x 2; then: 2-20 µg/kg per minute | Inodilator |
| Dobutamine | 2-20 µg/kg per minute IV/IO | Inotrope; vasodilator |
| Dopamine | 2-20 µg/kg per minute IV/IO | Inotrope; chronotrope; renal and splanchnic vasodilator in low doses; pressor in high doses |
| Epinephrine | 0.1-1 µg/kg per minute IV/IO | Inotrope; chronotrope; vasodilator in low doses; pressor in higher doses |
| Milrinone | 50-75 µg/kg IV/IO over 10-60 min then 0.5-0.75 µg/kg per minute | Inodilator |
| Norepinephrine | 0.1-2 µg/kg per minute | Inotrope; vasopressor |
| Sodium nitroprusside | 1-8 µg/kg per minute | Vasodilator; prepare only in D5W |
Alternative formula for calculating an infusion:
Infusion rate (mL/h) = [weight (kg) x dose (µg/kg/min) x 60 (min/h)]/concentration µg/mL).