In pediatric Advanced Life Support (ALS) for cardiac arrest, what is the initial dose of lidocaine given IV/IO?

• A. Lidocaine 0.5 mg/kg IV/IO
• B. Lidocaine 1.0 mg/kg IV/IO
• C. Lidocaine 2.0 mg/kg IV/IO
• D. Lidocaine 3.0 mg/kg IV/IO

Answer: (B)

In pediatric ALS for cardiac arrest, lidocaine is used to treat refractory ventricular arrhythmias by quickly reaching a therapeutic level after IV/IO administration. The initial dose is chosen as the standard starting amount because it reliably provides enough antiarrhythmic effect to help suppress ventricular activity while keeping the risk of toxicity at a minimum compared with higher doses. If the arrhythmia persists, additional dosing can be given at appropriate intervals with careful monitoring, up to the recommended safety limit. Doses that are too small may fail to control the rhythm, while larger starting doses increase the chance of adverse effects without added benefit at this stage.