Weight-based pediatric resuscitation drug doses — adrenaline, amiodarone, atropine, adenosine, calcium and more — for cardiac arrest and peri-arrest.
Pediatric Resuscitation Drug Doses
Confirm weight (measured, parental, or length-based tape), draw up to the per-kg dose, and cross-check the maximum (most are capped at the adult dose). Doses below are for IV/IO unless stated.
Cardiac arrest
| Drug | Dose | Max single dose | Notes |
|---|
| Adrenaline | 0.01 mg/kg (0.1 mL/kg of 1:10,000) | 1 mg | Every 3–5 min; first drug in non-shockable arrest |
| Amiodarone | 5 mg/kg bolus | 300 mg | Shockable arrest (VF/pVT); up to 2 further doses |
| Lidocaine | 1 mg/kg | 100 mg | Alternative to amiodarone in shockable arrest |
| Sodium bicarbonate | 1 mEq/kg | — | Only for prolonged arrest / specific indications |
Peri-arrest and arrhythmia
| Drug | Dose | Max | Indication |
|---|
| Atropine | 0.02 mg/kg | 0.5 mg/dose (no minimum dose, PALS 2020) | Vagal/AV-block bradycardia |
| Adenosine | 0.1 mg/kg rapid push (then 0.2 mg/kg) | 6 mg, then 12 mg | Stable SVT; large-bore + fast flush |
| Calcium chloride 10% | 20 mg/kg (0.2 mL/kg) | — | Hypocalcaemia, hyperkalaemia, Ca-blocker OD |
| Magnesium sulfate | 25–50 mg/kg | 2 g | Torsades, severe asthma |
| Dextrose 10% | 2–5 mL/kg (0.2–0.5 g/kg) | — | Documented hypoglycaemia |
Defibrillation / cardioversion
| Therapy | Energy |
|---|
| Defibrillation (VF/pVT) | 2 J/kg first, then 4 J/kg, then ≥4 J/kg (max 10 J/kg / adult dose) |
| Synchronised cardioversion | 0.5–1 J/kg, escalate to 2 J/kg |
Airway adjuncts
| Drug | Dose | Notes |
|---|
| Ketamine | 1–2 mg/kg | Induction; haemodynamically stable |
| Rocuronium | 1 mg/kg | Rapid-sequence intubation |
| Suxamethonium | 1–2 mg/kg | Caution: hyperkalaemia, burns |
Reminders
- 1:10,000 adrenaline = 0.1 mg/mL → 0.1 mL/kg. Do not confuse with 1:1,000.
- Atropine no longer has a mandated minimum dose — PALS 2020 dropped the old 0.1 mg minimum (the “paradoxical bradycardia” concern is not evidence-based); give 0.02 mg/kg even in small infants.
- Push adenosine as fast as possible with an immediate saline flush; effect is fleeting.
- Use a length-based resuscitation tape when weight is unknown.
For ET tube sizing and depth, see the dedicated calculators; for normal vitals by age, see the vital signs cheat-sheet.
Decision support for qualified clinicians only — verify against current primary guidelines and your clinical judgement.