Newborn care: if heart rate is less than 60 after airway assessment, what epinephrine dose is given IV/IO?

• A. 0.01 mg/kg
• B. 0.005 mg/kg
• C. 0.1 mg/kg
• D. 0.02 mg/kg

Answer: (A)

When a newborn’s heart rate remains below 60 beats per minute after establishing an airway and initiating ventilation, epinephrine is given to improve coronary and systemic perfusion. For IV or IO administration, the recommended dose is 0.01 mg per kilogram of epinephrine using a 1:10,000 concentration. This dilute solution delivers just enough vasoconstrictive effect to boost perfusion and raise the heart rate without overwhelming vasoconstriction. In practical terms, that dose translates to about 0.1 mL per kilogram of the 1:10,000 epinephrine solution given IV/IO. If the endotracheal route were used instead, a higher dose would be used (0.1 mg/kg of a 1:1000 solution), but the IV/IO route uses the 0.01 mg/kg dosing. Reassess the heart rate after administration and repeat dosing every 3–5 minutes as needed to maintain a heart rate above 60.