What is the recommended fluid bolus for pediatric patients in respiratory arrest?

What is the recommended fluid bolus for pediatric patients in respiratory arrest?

• A. 30 mL/kg
• B. 10 mL/kg
• C. 5 mL/kg
• D. 20 mL/kg

Answer: (D)

In pediatric resuscitation, the first step to improve perfusion when there’s concern for hypovolemia is a rapid bolus of isotonic crystalloid at 20 mL/kg. This amount reliably increases preload and cardiac output quickly without as much risk of fluid overload as larger single doses. You administer it and then reassess signs of perfusion—capillary refill, pulse quality, mental status, blood pressure, and urine output. If perfusion remains inadequate, you can repeat another 20 mL/kg for a total of about 40 mL/kg, and in many protocols continue up to around 60 mL/kg within the episode while monitoring closely. Smaller amounts like 10 or 5 mL/kg are usually insufficient to correct hypoperfusion promptly, and a 30 mL/kg bolus is not the standard initial dose even though it may be used as a subsequent bolus in some situations.

In pediatric resuscitation, the first step to improve perfusion when there’s concern for hypovolemia is a rapid bolus of isotonic crystalloid at 20 mL/kg. This amount reliably increases preload and cardiac output quickly without as much risk of fluid overload as larger single doses. You administer it and then reassess signs of perfusion—capillary refill, pulse quality, mental status, blood pressure, and urine output. If perfusion remains inadequate, you can repeat another 20 mL/kg for a total of about 40 mL/kg, and in many protocols continue up to around 60 mL/kg within the episode while monitoring closely. Smaller amounts like 10 or 5 mL/kg are usually insufficient to correct hypoperfusion promptly, and a 30 mL/kg bolus is not the standard initial dose even though it may be used as a subsequent bolus in some situations.