Primary cardiac causes of slow rates are rare with the pediatric population and may also be treated with atropine. The recommended dose of atropine is 0.02 mg/kg IV. The minimum dose is 0.1 mg, with a maximum single dose of 0.5 mg for children and 1.0 mg for adolescents. The dose may be repeated once, with a maximum total dose of 1.0 mg for children and 2.0 mg for adolescents. There is no particular proscription against further doses, but the maximum dose is considered to be fully vagolytic. If no response to atropine is seen, then dosing beyond the vagolytic amount is unlikely to be effective. If an effect is seen, but not maintained, further doses may be tried.
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