When a child is in cardiorespiratory arrest it is imperative to ensure effective oxygenation and ventilation because the primary cause of arrest in children is hypoxia. If the child then requires drugs during the resuscitation it is important that vascular access is gained. However, the most important drug in the resuscitation of a child is oxygen.

Vascular access is essential to enable drugs and fluids to be given during resuscitation. However, venous access can be difficult to establish during resuscitation of an infant or child. If venous access is not readily attainable, early intra-osseous access should be considered, especially if the child is in cardiac arrest or decompensated circulatory failure. If attempts at obtaining intravenous access are unsuccessful after 1 minute, an intra-osseous needle should be inserted. It is also possible to administer medication via the tracheal tube, although intravenous and intra-osseous routes are much preferred. The tracheal route can be used to administer medications such as adrenaline, atropine and naloxone as they are lipid-soluble.