Atropine dosing for pediatric bradycardia protocol?

• A. 0.02 mg/kg IV/IO (min 0.1 mg; max 0.5 mg)
• B. 0.3 mg/kg IV/IO
• C. 0.2 mg/kg IV/IO
• D. 0.02 mg/kg IV/IO

Answer: (A)

Atropine for pediatric bradycardia is dosed based on weight, using a standard amount of 0.02 mg/kg given IV or IO, with a minimum of 0.1 mg and a maximum single dose of 0.5 mg. This practice ensures the dose is meaningful across a range of child sizes while avoiding underdosing in larger children and overdosing in smaller ones. If the bradycardia persists and the protocol allows, a second dose can be given after a short interval, but the per-dose maximum of 0.5 mg remains. Mechanistically, atropine works by blocking muscarinic receptors, reducing parasympathetic (vagal) influence on the heart to help increase the heart rate. The other options don’t fit because they either use a much higher mg/kg amount or omit the minimum and maximum per-dose constraints that protect pediatric patients.