Hey Josh - 25 days out of residency and you're already unmasking my
ignorance- Ouch- ha, ha.
The data on atropine in this particular situation is quite limited (see
Roback et al; PEC 2004). The best data on intubation and atropine is in
neonates, and there, you are correct that most studies use 0.1 mg/kg.
I learned my atropine dose in 1987, and as you know, I am slow on the uptake
of new stuff!
I have probably used the resusc dose 50 times without an adverse event.
While some may say that is not 'evidence-based'- it is evidence of
something, for what it's worth. Since the incidence of profound bradycardia
with intubation in critical kids is fairly infrequent, a randomized study
would require about 1000 kids in each limb to show one dose is better than
the other. Since atropine is about 5 cents a metric ton, I will not hold my
breath awaiting this study!
Go get em Josh - and thanks for the update.
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