What is the recommended epinephrine dose during pediatric cardiac arrest?

• A. 0.01 mg/kg IV/IO every 3-5 minutes (max single dose 1 mg)
• B. 0.1 mg/kg IV/IO every 3-5 minutes
• C. 0.001 mg/kg IV/IO every 1-2 minutes
• D. 0.02 mg/kg IV/IO every 5-10 minutes

Answer: (A)

In pediatric cardiac arrest, the goal is to improve blood flow to the heart and brain during CPR, and the way to do that is with a weight-based dose of epinephrine given IV or IO every 3–5 minutes. The standard dose is 0.01 mg/kg (that’s 10 micrograms per kilogram) using a 1:10,000 concentration. This dose is repeated at 3–5 minute intervals to maintain perfusion pressure throughout the arrest. In practice, this translates to a per-dose amount that is small enough to reduce the risk of serious side effects while still providing the needed vasoconstrictive and inotropic effects; the usual pediatric per-dose cap is around 0.1 mg, so giving much more than that per dose increases the chance of adverse effects without proven benefit. The essential idea is weight-based dosing at 3–5 minute intervals to support perfusion during ongoing CPR.