During neonatal resuscitation, a newborn's heart rate remains 40 bpm despite effective ventilation and coordinated chest compressions. Intravenous access has been obtained via an umbilical venous catheter. What is the correct dose of intravenous epinephrine?

• A 0.01 to 0.03 mg/kg of 1:1,000 solution
• B 0.1 to 0.3 mg/kg of 1:10,000 solution
• C 0.01 to 0.03 mg/kg of 1:10,000 solution ✓
• D 0.5 mg/kg of 1:10,000 solution

Explanation

The NRP dose of IV epinephrine is 0.01 to 0.03 mg/kg per dose of the 1:10,000 concentration, given every 3 to 5 minutes, followed by a saline flush. The 1:1,000 preparation used subcutaneously in anaphylaxis is ten times more concentrated and would cause a dangerous overdose if given at this weight-based dose. Endotracheal epinephrine requires a higher dose of 0.05 to 0.1 mg/kg but IV is the preferred route.

Reference: Fanaroff and Martin's Neonatal-Perinatal Medicine, 11th ed.

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