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epinephrine, it should be delivered via IV route as soon as vascular access is established Epinephrine Epinephrine is indicated when the infant’s HR remains less than 60/min, despite adequate ventilation with 100% oxygen and coordinated chest compressions (see Table 9.10 for dosing) It may be administered via an umbilical venous catheter, a peripheral IV, an IO line, or the ET tube and repeated every to minutes IV epinephrine should be administered as rapidly as possible and followed by a 1mL normal saline flush High-dose epinephrine is not recommended and may cause harm TABLE 9.10 MEDICATIONS FOR NEONATAL RESUSCITATION Volume Expansion Volume expansion is indicated when the infant’s HR has not responded adequately to other resuscitative measures or if blood loss is suspected Isotonic crystalloid (normal saline, lactated Ringer’s) or blood may be administered intravenously in 10 mL/kg aliquots for volume expansion Rapid infusion of volume expanders should be avoided in premature infants given association with IVH Albumin-containing solutions are not recommended because of cost, limited availability, risk of infection, and potential increased mortality Glucose Hypoglycemia in the neonate is associated with increased risk for brain injury and adverse outcomes with hypoxic-ischemic events Therefore, the administration of IV glucose infusion should be considered as early as is practical after initial resuscitative measures The goal of glucose infusion should be to maintain euglycemia Other Medications ED stabilization should focus on basic resuscitation interventions outlined above Other medications such as buffers, narcotic antagonist, vasopressors, or surfactant