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Paediatric PEA arrest — DipIMC MCQ

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HardResuscitationPaediatric PEA arrestDipIMC

A 3-year-old is in cardiac arrest from severe sepsis. Ventilation and compressions are effective, IO access is established and the rhythm is pulseless electrical activity. Which adrenaline dose is indicated during paediatric ALS?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Give adrenaline 10 micrograms/kg IV or IO

The best answer is “Give adrenaline 10 micrograms/kg IV or IO”. Paediatric non-shockable cardiac arrest requires adrenaline 10 micrograms/kg IV or IO as soon as access is available, while high-quality CPR, ventilation and correction of reversible causes continue. The fixed 1 mg adult dose would be excessive for a small child. Amiodarone is used for refractory shockable rhythms, and atropine is not the routine first arrest drug for PEA.

Reference: Resuscitation Council UK, 2025 Paediatric life support: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/paediatric-basic-life-support-guidelines