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The femoral vein is the easiest central vein to access in the critically ill child and has less complications Central venous access provides a more secure route, allows the capability of monitoring central venous pressure, and allows for blood sampling In adults, this route has been shown to provide more rapid onset of action and higher peak drug levels that theoretically could affect outcome This has not been shown to be the case in the pediatric patient In a child with uncompensated shock or arrest, IO access is obtained first for rapid initial resuscitation and central venous access may follow (see Chapter 130 Procedures ) DRUGS OF RESUSCITATION Estimating Body Weight Drug doses, fluid therapy, and equipment size are weight and size based The 50th percentile weight from a standardized growth curve can be used to estimate weight based by known/estimated age The Broselow tape allows a simple, accurate method of estimating the weight and drug doses based on the measured height ( Fig 9.13 ) In the absence of compelling research, AHA currently recommends using the actual or tape-based weight for obese children rather than an ideal weight Drug doses should never exceed the adult maximum dose Many handheld computer programs are available to calculate pediatric resuscitation drug doses (see Table 9.6 for doses and comments on common resuscitation medications)