Bicarbonate

(0.5 mEq/ml)

Documented Metabolic acidosis

1 - 2 mEq/kg IV slowly

NOT routinely given for resuscitation.

Note: Use only 0.5 mEq/ml solution for infants

Epinephrine

(1 : 10,000)

Severe Bradycardia and hypotension

Heart rate should rise to

> 100 within 30 seconds

after bolus infusion.

0.1 - 0.3 ml/kg

IV or intratracheal

equal to 0.01-0.03 mg/kg/dose of 1:10,000 concentration

For continuous infusion -

start at 0.05 mcg/kg/min.

Warning: Never use undiluted

1 : 1,000 concentration.

And NEVER inject into an artery

IV push or IT followed by 1 ml normal saline

Do not mix with bicarbonate

If heart rate remains < 100, may repeat dose q 5 min. as needed

Volume Expanders

Plasmanate, NS

Hypotension or hypovolemia with evidence of acute blood loss or decreased effective plasma volume

10-15 ml/kg IV

over at least 10 min.

but preferably

over 30 - 60 min.

Consider if poor response to resuscitative efforts or weak pulses with a good heart rate

Glucose

(D10W)

Hypoglycemia

IV - 2 ml/kg of D10W

and/or constant infusion of D10W at rate of 100 ml/kg/d

(8 mg glucose/kg/min.)

Naloxone

(Narcan, 1.0 mg/ml)

Severe respiratory depression AND maternal narcotic within the past 4 hours

0.1 ml/kg

inject rapidly

IM, IV, IT, SQ

Delivery room: 1 ml vial.

May repeat in 3 - 5 min. If no response during resuscitation

Duration (1-4 hr) may be less than the narcotic, needing repeated doses

Dopamine

To give 10 mcg/kg/min.

@ 1 ml/hr :

weight x 30 = mg of dopamine

(in kg) in 50 ml D5W/NS

Begin at 5 mcg/kg/min.

May increase in increments of 2.5 - 5 mcg/kg/min. as needed up to 20 mcg/kg/min.

Consider if poor peripheral perfusion, evidence of shock, or thready pulses after epinephrine and volume expansion (and bicarbonate)

Phenobarbital

(Anticonvulsant)

*Loading dose 15 - 20 mg/kg

IV push; Maximum loading dose 30 - 40 mg/kg

Maintenance dose:

2 - 4 mg/kg/dose q 12 hours

IV, IM , or PO

*may cause respiratory depression