What is the pediatric epinephrine dose for bradycardia when using a 1 mg/mL concentration?

• A. 0.01 mg/kg IV/IO dose
• B. 0.1 mg/kg ET dose
• C. 0.1 mg/kg IV/IO dose
• D. 1 mg/kg IV/IO dose

Answer: (B)

In pediatric bradycardia, epinephrine dosing depends on the route because absorption differs. Intravenous or IO dosing uses a small amount (0.01 mg/kg of a 1:10,000 solution). Endotracheal administration is less reliably absorbed, so the dose is increased tenfold to ensure an adequate amount reaches the circulation, typically 0.1 mg/kg of the same concentration. With a 1 mg/mL preparation, that endotracheal dose corresponds to 0.1 mL/kg. So the best choice is 0.1 mg/kg given via the endotracheal route because it accounts for the need to overcome variable absorption at the ET site.