Correct Amiodarone Dose in Pediatric Advanced Life Support (PALS)

Amiodarone doses should be adhered to in order to effectively treat tachycardia.

What is Amiodarone and Its Role in PALS?

Amiodarone is a medication commonly used in Pediatric Advanced Life Support (PALS) to treat various cardiac arrhythmias. Arrhythmias are irregular heartbeats that can be life-threatening, so it is important to know the correct dosage of amiodarone to administer to children in order to effectively treat the arrhythmia.

RELATED: Atropine: Your Guide to Bradycardia Treatment

Understanding Amiodarone Dose Guidelines for PALS

In PALS, the recommended initial dose of amiodarone for a child with a pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) is 5 mg/kg IV. This initial dose can be repeated once if the arrhythmia persists after defibrillation. The maximum total dose of amiodarone that can be administered in a 24-hour period is 15 mg/kg.

Dose guidelines in short:

SVT and VT with a pulse 

5 mg/kg IV/IO loading dose over 20–60 minutes with max dose: 300 mg. 

Repeat to daily max of 15 mg/kg (2.2 g in adolescents).

VF and pVT

5 mg/kg IV/IO bolus with max dose: 300 mg. 

Repeat to daily max of 15 mg/kg (2.2 g in adolescents).

RELATED: The Complete ACLS Drug Dosages Chart for 2022

Amiodarone is used in PALS to treat various cardiac arrhythmias.
A child’s arm with an IV inserted rests on a white hospital bed.

How to Determine the Correct Amiodarone Dose for a Specific Patient

For children with a stable wide-complex tachycardia (WCT), the recommended dose of amiodarone is 5 mg/kg intravenously over 20-60 minutes, with a maximum total dose of 15 mg/kg in 24 hours. If the WCT is unstable, or if the child has symptoms such as chest pain or decreased blood pressure, then synchronized cardioversion should be performed instead of administering amiodarone.

Practical Tips to Administering an Effective Amiodarone Dose in a Pediatric Setting

It is essential that amiodarone be administered only by trained healthcare professionals who are familiar with its use and potential side effects. The medication can have serious side effects, including hypotension, bradycardia, and pulmonary toxicity. In addition, amiodarone can interact with other medications, so it is important to review the child’s medication list and medical history before administering the medication.

In summary, amiodarone is an important medication in PALS for treating cardiac arrhythmias in children. The correct dosage of amiodarone depends on the type of arrhythmia and the child’s weight, and it is important to follow the recommended dosing guidelines. Healthcare professionals who are responsible for administering amiodarone should be familiar with the medication’s potential side effects and interactions, and should monitor the child closely for any adverse reactions.

RELATED: Pediatric (PALS) vs Adult (ACLS) Drug Doses: What You Need to Know

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