APLS Drug Doses for Paediatric Cardiac Arrest

APLS drug doses for paediatric cardiac arrest - overview and practical guidance

This reference summarises recommended Advanced Paediatric Life Support (APLS / PALS) drug doses, usual maximums, preferred routes and practical caveats for paediatric cardiac arrest. Doses and timing follow Resuscitation Council UK - Paediatric Advanced Life Support (PALS).

Recommended drug doses (APLS / PALS)

(Primary source: Resuscitation Council UK - Paediatric Advanced Life Support. May 2021; updated Jun 2024. See also Paediatric Life Support professional summary, 27 Oct 2025.)

Core principles and practical points

• Route: IV or intraosseous (IO) administration is the preferred and most reliable route during cardiac arrest. Endotracheal administration is unreliable and should be a last resort.
• Dosing maxima: Paediatric weight‑based doses should be capped at adult maxima where specified (for example adrenaline 1 mg, amiodarone 300 mg). Always state both the per‑kg dose and the absolute maximum.
• Timing and algorithm links: Tie drug timing to the PALS algorithm - for example amiodarone immediately after the 3rd shock for shock‑refractory VF/pVT; adrenaline dosing every 3-5 minutes during arrest. Flush the line after bolus doses to ensure delivery.
• Preparation: Use preprinted paediatric arrest drug charts or length‑based tapes to reduce calculation errors. Prelabel syringes with drug, concentration, dose and patient weight where possible. Verify ampoule concentrations before drawing up.
• Units: Be explicit with units (microgram vs...