Furosemide | Volume overload, pulmonary edema | 1 mg/kg/dose, IM, IV | | | Yes |
Lorazepam | Anticonvulsant | 0.05 mg/kg/dose IV, infuse over 3–5 minutes | May cause respiratory depression and hypotension, may repeat in 10–15 minutes | | Yes |
Naloxone | Narcotic reversal | 0.1 mg/kg IM/IV (IV preferred; IM acceptable but delayed onset of action). ETT route: no studies in neonates | Not recommended as part of initial resuscitation of newborns with respiratory depression in delivery room. If respiratory depression continues, naloxone may be given if mother had narcotics within 4 hours of delivery. | | Yes |
Phenobarbital | Anticonvulsant | 15–20 mg/kg IV load over 15–30 minutes | Respiratory depression possible if diazepam used first. Follow with maintenance dose. | | Yes |
Phenytoin | Anticonvulsant | 15–20 mg/kg IV load | IV rate 0.5 mg/kg/min maximum; mix only with NS. | | Yes |
Sodium bicarbonate | Documented metabolic acidosis with adequate ventilation, hyperkalemia | 1–2 mEq/kg IV over at least 30 minutes or more | Use 0.5 mEq/mL; infuse over 30 minutes or more. | | Yes |
Volume Expansion |
Normal saline (preferred) or lactated Ringer’s solution | Volume expansion | 10 mL/kg IV over 5–10 minutes; may repeat | Check Hct and serum glucose before and after dose. | Yes | Yes |
O Rh-negative packed RBCs | Volume expansion (severe anemia/blood loss) | 10 mL/kg IV over 5–10 minutes; may repeat | If time permits, blood should be cross-matched to the mother. | Yes (not preferred) | Yes |
Atropine | Bradycardia | 0.01–0.03 mg/kg/dose IV, IM, ETT; repeat every 10–15 minutes | For ETT use, dilute with NS. | | Yes |
Calcium gluconate (10%) (100 mg/mL) | Hyperkalemia Hypocalcemia | Ca gluconate 100–200 mg/kg slow IV over 10–30 minutes (1.0–2.0 mL/kg) | Infuse slowly; caution with digitalized patient; tissue necrosis if extravasation. Can also use CaCl 20–30 mg/kg. | | Yes |
Dextrose | Hypoglycemia Hyperkalemia (used with insulin) | 100–500 mg/kg/dose IV (1–5 mL/kg/ dose D10W) | D10 = 100 mg/mL; D12.5 = 125 mg/mL; D25 = 250 mg/mL (D25 only in central line). | Yes | Yes |
Dobutamine | Cardiogenic shock, hypotension due to refractory CHF | 2–15 mcg/kg/min, increase every 10 minutes to maximum 40 mcg/kg/min | Mix in D5W, NS, LR. | | Yes |
Dopamine | Hypotension, agonal heart | 5 mcg/kg/min, increase to a maximum of 40 mcg/kg/min | Mix in D5W, NS, LR. | | Yes |
Cardioversion/defibrillation | VT, VF, SVT, atrial fib/flutter | 1–4 joules/kg, increase 50–100% each time | Synch switch off for VF. | | — |
Epinephrine (1:10,000) | Asystole, bradycardia, hypotension (acute) | 0.1–0.3 mL/kg/dose of 1:10,000 IV; ETT only 0.5–1 mL/kg/dose of 1:10,000 (dilute with NS) | Do not use 1:1000; for ETT use, dilute in 1–2 mL NS; NRP, AHA, AAP suggests higher dose if by ETT. | | Yes |
Endotracheal tube (uncuffed) | 2.5 mm internal diameter (ID) 3.0 mm ID 3.5 mm ID 3.5–4.0 mm ID | <1000 g or <28 weeks 1000–2000 g or 28–34 weeks 2000–3000 g or 34–38 weeks >3000 g or >38 weeks | | | — |