Is lidocaine recommended for endotracheal administration in pediatric arrests?

• A. Lidocaine is not recommended for ET tube use in pediatric patients.
• B. Lidocaine is routinely used via ET tube in pediatric arrests.
• C. Lidocaine should always be given with a bolus via ET tube.
• D. Lidocaine is only given intravenously.

Answer: (A)

The key point is that route of administration matters for drug effect during pediatric resuscitation. Endotracheal administration of lidocaine is not recommended because absorption from the airway is highly unreliable and unpredictable, leading to variable and hard-to-control plasma levels. This makes it easy to underdose (no antiarrhythmic effect) or overdose (risk of toxicity). intravenous or intraosseous delivery provides a reliable, controllable dose and onset, which is essential during pediatric arrests. Since there is no established, safe dosing for lidocaine via the endotracheal route in children, it should not be used that way. If lidocaine is considered in a pediatric arrest, it should be given IV/IO rather than through the endotracheal tube, with other options like amiodarone or epinephrine used per guidelines as appropriate.