In pediatric ALS, what is the repeat lidocaine dose after five minutes during cardiac arrest?

• A. 0.5 mg/kg
• B. 1.0 mg/kg
• C. 0.25 mg/kg
• D. 2.0 mg/kg

Answer: (A)

During pediatric cardiac arrest, lidocaine is used for refractory ventricular arrhythmias with an IV/IO bolus strategy. The typical plan starts with a 1 mg/kg dose. If the rhythm remains unstable and lidocaine is still needed after about 5 minutes, a repeat 0.5 mg/kg bolus is given. This smaller subsequent dose helps sustain antiarrhythmic effect while keeping the total dose within safe limits (not exceeding 3 mg/kg overall). Monitor for signs of lidocaine toxicity such as changes in mental status or heart rate and blood pressure.