Which drug is indicated as part of the management of pediatric resuscitation for asystole?

• A. Epinephrine.
• B. Lidocaine.
• C. Amiodarone.
• D. Atropine.

Answer: (A)

In asystole during pediatric resuscitation, the focus is on improving perfusion with epinephrine. Epinephrine’s alpha-adrenergic effects raise aortic diastolic pressure and enhance coronary and cerebral perfusion during CPR, which increases the chance of return of spontaneous circulation. The typical dose is 0.01 mg/kg (1:10,000) given IV or IO, repeated every 3–5 minutes during CPR.

Lidocaine and amiodarone are antiarrhythmics used for shockable rhythms (like ventricular fibrillation or pulseless VT), not for a nonshockable rhythm like asystole. Atropine has limited utility in true asystole under current pediatric guidelines, so it is not a mainstay of management in this scenario.