What is the dose for endotracheal epinephrine in pediatric arrest?

• A. 0.01 mg/kg of 1:10,000
• B. 0.1 mg/kg of 1:10,000 (10x IV/IO dose)
• C. 1 mg/kg of 1:10,000
• D. 0.5 mg/kg of 1:10,000

Answer: (B)

Endotracheal epinephrine in pediatric arrest is given at 0.1 mg/kg of a 1:10,000 solution, which is ten times the IV/IO dose of 0.01 mg/kg. The reason is that absorption from the airway is unreliable and limited, so a higher endotracheal dose helps ensure the drug reaches the circulation to improve perfusion during CPR. After giving the ET dose, a quick saline flush is typically used to help delivery, and IV/IO access should be established for subsequent dosing every 3–5 minutes as needed. Doses like 1 mg/kg or 0.5 mg/kg are not appropriate for endotracheal administration in this scenario, and the IV/IO dose is the smaller 0.01 mg/kg amount.