What are the PALS recommendations for pulseless arrest (PEA, asystole)?
• Give epinephrine for PEA or asystole intravascularly (IV or IO route) as a standard dose (0.01 mg/kg). This can be delivered as 0.1 mL/kg of a 1:10,000 solution of epinephrine. Use of vasopressin is considered class indeterminate (not enough evidence to recommend for or against) in pediatric arrests.
• If epinephrine for PEA or asystole is administered by the ETT, give as a higher dose (0.1 mg/kg). This dose can be delivered as 0.1 mL/kg of a 1:1000 solution of epinephrine. An IV or IO route of administration is preferred, however, if at all possible.
• Higher-dose epinephrine (0.1 mg/kg; 0.1 mL/kg of a 1:1000 solution) is not routinely recommended for subsequent doses of epinephrine given through an IV or IO route.