PALS Drugs: Adrenaline, Adenosine, Amiodarone, Atropine and More

PALS uses a short list of drugs, each given per kilogram and each tied to a point in a paediatric algorithm. The PALS course teaches the doses in context and how to calculate them fast.

Cardiac arrest

• Adrenaline — every 3 to 5 minutes; commonly taught as 0.01 mg/kg IV or IO.
• Amiodarone or lidocaine — for VF or pulseless VT that persists after shocks.

See the cardiac arrest algorithm.

Rhythm problems

• Adenosine — rapid push with a flush for SVT — tachycardia.
• Adrenaline and atropine — bradycardia.

Respiratory and allergic emergencies

Salbutamol and steroids for asthma, dexamethasone and nebulised adrenaline for croup, intramuscular adrenaline for anaphylaxis — see lower and upper airway guides.

Shock

Isotonic crystalloid boluses and vasoactive infusions — see fluid resuscitation and septic shock. Check and correct glucose.

Dosing safety

Weigh the child or estimate weight with a length-based tape, use pre-calculated charts, never exceed the adult dose, and read back every dose with closed-loop communication. See weight-based dosing. The adult equivalents are in ACLS drugs.

This guide summarises what the PALS course teaches, for education only. It is not a clinical protocol: follow the current American Heart Association guidelines, linked below, and your institution’s paediatric policies.

More PALS guides: PALS assessment, algorithms and skills

• PALS Course in Abu Dhabi — dates, format and booking
• The PALS Systematic Approach: Assess, Categorise and Treat a Sick Child
• Respiratory Distress vs Respiratory Failure in Children
• Upper Airway Obstruction in Children: Croup, Foreign Bodies and Anaphylaxis
• Lower Airway Obstruction in Children: Asthma and Bronchiolitis
• Lung Tissue Disease and Disordered Control of Breathing in PALS
• Shock in Children: The Four Types Taught in PALS
• Septic Shock in Children: Recognition and the First Hour
• Fluid Resuscitation in Children: Boluses and Reassessment
• PALS Bradycardia Algorithm: Oxygen First, Then CPR and Drugs
• PALS Tachycardia: Sinus Tachycardia vs SVT in Children
• PALS Cardiac Arrest Algorithm: Shockable and Non-Shockable Rhythms
• PALS Post-Cardiac Arrest Care: After ROSC in Children
• Weight-Based Dosing in PALS: Estimating Weight and Avoiding Errors
• Intraosseous (IO) Access in PALS: When and How It Is Used
• Paediatric Vital Signs by Age: Heart Rate, Breathing and Blood Pressure
• PALS Defibrillation and Cardioversion: Energies per Kilogram
• All PALS guides, by topic

Other life support and first aid courses: BLS Course · ACLS Course · First Aid Course · Training calendar

Frequently asked questions

What is the paediatric adrenaline dose in cardiac arrest?

Commonly taught as 0.01 mg/kg IV or IO, every 3 to 5 minutes; follow current guidelines and local charts.

Which drug treats SVT in children?

Adenosine, after vagal manoeuvres.

When is atropine used in PALS?

For bradycardia due to increased vagal tone or primary AV block.

Can the paediatric dose exceed the adult dose?

No, the calculated dose should not exceed the adult dose.

How are PALS doses calculated?

Per kilogram, using the child's weight or an estimate from a length-based tape.

Sources and further reading

What we teach follows the awarding body and the UAE health authorities. For the definitive position on a course or licensing question, these are the places to check.

• CPR and ECC Guidelines — American Heart Association
• PALS course options — American Heart Association

Last reviewed 21 September 2026 by the training team at Safety First Medical Services, an American Heart Association training centre at Addax Office Tower, Al Reem Island, Abu Dhabi. Call +971 55 761 9841 or email training@safetyfirstmed.ae.