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Part 3, Chapter 13: Manual Exhibit I

Drugs for Newborn Resuscitation

Drug Concentration Dose (mg or meq) Dose (ml) Frquency Indication
*Epinephrine 1:10,000 (0.1meq/ml) .01 mg/kg .1cc/kg q 5-10 min. Asystole, bradycardia, ventricular fibirillation
*Atropine 1mg/ml 0.02mg/kg 0.2cc/kg once-may repeat in 5 min. single dose 0.1mg. Sinus bradycardia, AV block
Ca Choloride 10% (100mg/ml) 20mg/kg q 10 min. Documented hypocalcemia, hyperkalemia, hypermagnesemia
*Naloxone (Narcan) 0.4 mg/ml 0.02 .01 mg/kg       Narcotic Overdose (may precipitate withdrawl in infant or addicted mother)
NAHCO3    1-2 meq/kg       Documented acidosis with adquate ventilation, hyperkalemia
Dextrose 10% mini bolus 1-2 cc/kg followed by 80-100 cc/kg/day flow rate    as needed follow serum glucose Hypoglycemia
Plasma, L.R., whole blood, normal saline       10ml/kg may repeat x1 Blood loss, hypotension volume depletion
Albumin 25% (dilute) 4 ml albumin dilute with 16 ml saline equals 1gm. Give 1gm/kg over 10 min.       Blood loss, hypotension volume depletion

* = May be given via ET tube
Reference:  Textbook of Advanced Life Support, AHA, AAP, 1988.

The equipment and drugs for resuscitation must be thoughtfully arranged and carefully maintained.  Wall mounting on peg-board or arrangement in a "crash cart" (or a combination) is recommended.  All personnel must be familiar with the equipment and drugs and periodically practice the resuscitation routines.  Nursing staff is responsible for assuring that all equipment is in working order and drugs are stocked.  This should be done each change of shift and documented.