In pediatric cardiac arrest with asystole or PEA, what is the recommended epinephrine dose?

• A. 0.01 mg/kg IV/IO of 1:10,000
• B. 0.001 mg/kg IV/IO of 1:10,000
• C. 0.01 mg/kg IV/IO of 1:1,000
• D. 0.1 mg/kg IV/IO

Answer: (A)

In pediatric cardiac arrest with asystole or PEA, epinephrine is used to boost perfusion during CPR by causing vasoconstriction that raises the diastolic aortic pressure and improves blood flow to the heart and brain. The best dose is 0.01 mg/kg given IV or IO of a 1:10,000 solution, and it should be repeated every 3–5 minutes during CPR. This concentration (1:10,000) provides the correct potency for a pediatric patient, translating to a small, precise volume (about 0.1 mL/kg) that achieves the needed perfusion without excessive vasoconstriction. A dose of 0.001 mg/kg would be too small to have a meaningful effect, while using a 1:1,000 concentration would be far stronger and risk adverse effects, and 0.1 mg/kg would be far too high for a child.