kg
search
Input the child's age and weight (if known) above
Medications, Fluids & Shocks collapse
Cardiac Arrest Dose Volume Comment collapse
defibrillation 4 J Round up to nearest available setting.
Consider increasing if first shock unsuccessful.
adrenaline IV/IO 10 microg 1 mg/10 mL = 1:10,000 Flush with 5 mL of sodium chloride 0.9%.
adrenaline ETT 100 microg 1 mg/1 mL = 1:1,000 Only until IV/IO access obtained.
amiodarone IV/IO 5 mg 150 mg/3 mL Flush with 5 mL of glucose 5%.
sodium chloride 0.9% IV/IO 20 mL
atropine IV/IO 20 microg 600 microg/1 mL Consider for persistent asystole / bradycardia.
Induction Dose Volume Comment collapse
fentanyl IV/IO 4 microg 100 microg/2 mL First line induction agent <3 months.
Reduce dose in shock.
ketamine IV/IO 200 mg/2 mL First line induction agent in shock but reduce dose.
Not recommended <3 months.
propofol IV/IO 200 mg/20 mL Avoid or reduce dose in shock.
Not recommended <3 months.
midazolam IV/IO 5 mg/5 mL Optional adjunct to ketamine induction especially in head injury.
Avoid or reduce dose in shock.
atropine IV/IO 600 microg/1 mL Adjunct prior to suxamethonium to prevent bradycardia.
Not usually required ≥1 year.
suxamethonium IV/IO 100 mg/2 mL Pretreat with atropine <1 year.
rocuronium IV/IO 1.5 mg 50 mg/5 mL Pretreat with atropine <3 months.
pancuronium IV/IO 4 mg/2 mL First choice in babies with cardiac disease (no bradycardia).
Not generally used ≥1 year.
metaraminol IV/IO Dilute 10 mg/1 mL ampoule in 100 mL sodium chloride 0.9% → 100 microg/mL.
Bolus  mL, repeat as needed.
Not recommended <1 year or if bradycardic (use adrenaline).
adrenaline IV/IO Add 1 mL of 1 mg/10 mL (1:10,000) to 9 mL sodium chloride 0.9% → 10 microg/mL.
Bolus  mL, repeat as needed.
Recommended push dose vasopressor in infants or if bradycardia.
sugammadex IV/IO 16 mg 500 mg/5 mL Reverses rocuronium.
[RHH ED: kept in anaesthetic trolley, key in disaster corridor cupboard].
Post Intubation Sedation Dose Volume Comment collapse
morphine infusion 1 mg 10 mg/1 mL Make up to 50 mL with sodium chloride 0.9%.
Titrate 1-3 mL/h (20-60 microg/kg/h).
midazolam infusion 3 mg 50 mg/10 mL Make up to 50 mL with sodium chloride 0.9%.
Titrate 1-5 mL/h (1-5 microg/kg/min).
propofol infusion 50 mL 500 mg/50 mL Neat. Titrate - mL/h (1-4 mg/kg/h).
Not recommended <5 years.
Procedural Sedation Dose Volume Comment collapse
ketamine IV/IO 200 mg/2 mL Give further incremental doses  mg as needed.
Not recommended <3 months.
ketamine intramuscular 200 mg/2 mL Repeat half to full dose after 10 min if sedation inadequate.
Not recommended <3 months.
propofol IV/IO 200 mg/20 mL Required dose very variable, titrate carefully.
Avoid in shock. Not generally recommended <5 years.
fentanyl IV/IO 2 microg 100 microg/2 mL
Asthma life-threatening, ≥1 year old Dose Volume Comment collapse
salbutamol nebulised Continuous for 1 hour.
ipratropium nebulised Three nebules in first hour, added to salbutamol.
hydrocortisone IV/IO 100 mg/2 mL water Repeat 6 hourly.
methyl­prednisolone IV/IO 1,000 mg/10 mL water Repeat 6 hourly.
Use methylprednisolone sodium succinate (not acetate).
magnesium sulfate 50% IV/IO load 10 mmol/5 mL Dilute with  mL sodium chloride 0.9% (total volume  mL).
Give over 20 min.
If response, follow with infusion.
magnesium sulfate 50% infusion 10 mmol/5 mL Precede with IV/IO load.
Make up to 50 mL with sodium chloride 0.9%.
Give at  mL/h (0.12 mmol/kg/h).
aminophylline IV/IO load 250 mg/10 mL Dilute with  mL glucose 5%.
Give over 60 min.
salbutamol IV/IO load 5 mg/5 mL Neat. Give over 60 min (5 microg/kg/min).
Follow with infusion.
salbutamol infusion 5 mg/5 mL Precede with IV/IO load.
Neat. Titrate - mL/h (1-2 microg/kg/min).
adrenaline intramuscular / infusion Consider if peri-arrest. Dosing as per Anaphylaxis.
Croup severe Dose Volume Comment collapse
adrenaline nebulised 1 mg/1 mL = 1:1,000 Repeat as necessary.
Consider discharge if stridor free at rest 4 hours after single dose.
dexamethasone oral, IV/IO, intramuscular Reduce dose to  mg in non-severe croup.
Apnoea neonatal Dose Volume Comment collapse
caffeine citrate IV load 40 mg/2 mL Neat. Give over 30 min.
2 mg of caffeine citrate is equivalent to 1 mg of caffeine base.
Shock Dose Volume Comment collapse
sodium chloride 0.9% IV/IO 20 mL If inadequate response, repeat bolus.
Consider inotropes beyond  mL (40 mL/kg).
metaraminol IV/IO Dilute 10 mg/1 mL ampoule in 100 mL sodium chloride 0.9% → 100 microg/mL.
Bolus  mL, repeat as needed.
Not recommended <1 year or if bradycardic (use adrenaline).
adrenaline IV/IO Add 1 mL of 1 mg/10 mL (1:10,000) to 9 mL sodium chloride 0.9% → 10 microg/mL.
Bolus  mL, repeat as needed.
Recommended push dose vasopressor in infants or if bradycardia.
noradrenaline / adrenaline infusion 0.15 mg 1 mg/1 mL = 1:1,000 Make up to 50 mL with sodium chloride 0.9%.
Titrate 1-20 mL/h (0.05-1 microg/kg/min).
Central vein only. Use low concentration adrenaline infusion in Anaphylaxis section peripherally while obtaining central access.
dobutamine infusion 250 mg/20 mL Make up to 50 mL with sodium chloride 0.9%.
dopamine infusion 200 mg/5 mL Make up to 50 mL with sodium chloride 0.9%.
Titrate 0.5-2 mL/h (5-20 microg/kg/min).
Not recommended ≥3 months.
Anaphylaxis Dose Volume Comment collapse
adrenaline intramuscular 10 microg 1 mg/1 mL = 1:1,000 Administer lateral thigh.
Repeat after 5 min if not improving, then consider infusion.
EpiPen adrenaline intramuscular EpiPen Jr 7.5-20 kg. EpiPen >20 kg.
Administer lateral thigh.
Repeat after 5 min if not improving, then consider infusion.
adrenaline infusion 1 mg 1 mL 1 mg/1 mL = 1:1,000 Dilute in 1 L sodium chloride 0.9%.
Titrate - mL/h (≈0.1-0.4 microg/kg/min).
Initial infusion only, use standard high concentration infusion after 1 hour.
Haemorrhage severe information Dose Volume Comment collapse
tranexamic acid IV/IO 15 mg 1000 mg/10 mL Within 3 hours of trauma.
sodium chloride 0.9% IV/IO 10 mL Warmed.
Only until blood products available.
If inadequate response, repeat bolus.
PRBC (packed red blood cells) IV/IO 5 mL Warmed.
Repeat bolus while shock remains. Aim 1:1 ratio with FFP.
FFP (fresh frozen plasma) IV/IO 5 mL Warmed.
Repeat bolus while shock remains. Aim 1:1 ratio with PRBC.
cryoprecipitate IV/IO 10 mL Warmed.
Bolus aiming fibrinogen >1 g/L.
calcium CHLORIDE 10% IV/IO 0.1 mL Slow IV push into a large vein.
Aim VBG Ca2+ >1.0 mmol/L.
platelets IV/IO 10 mL Warmed.
Bolus aiming platelets >50 /nL (>100 /nL if head injury).
Arrhythmia Dose Volume Comment collapse
adenosine IV/IO 0.1 mg 6 mg/2 mL For SVT (supraventricular tachycardia).
Increase to  mg, then  mg if unsuccessful.
Use most central vein available (eg antecubital) & follow with rapid flush.
magnesium sulfate 50% IV/IO load 10 mmol/5 mL For polymorphic VT (ventricular tachycardia) / torsades de pointes.
Dilute with  mL sodium chloride 0.9% (total volume  mL).
Give over 5 min.
cardioversion 0.5 J Round up to nearest available setting. Ensure defibrillator is synchronised.
Increase to  J, then  J if unsuccessful.
Use procedural sedation.
Congenital Heart Disease Dose Volume Comment collapse
alprostadil Prostin VR infusion 60 microg 500 microg/1 mL Make up to 50 mL with sodium chloride 0.9%.
Titrate 0.5-3 mL/h (10-60 nanogram/kg/min).
Maintains patent ductus arteriosus. Only indicated in neonates.
Hyperkalaemia Dose Volume Comment collapse
calcium GLUCONATE 10% IV/IO 0.11 mmol 2.2 mmol/10 mL Give into a large vein over 2-5 min if unstable (over 20 min if stable).
Repeat dose after 5 min if ECG hasn't normalised.
Dose also appropriate for critical hypocalcaemia.
insulin Actrapid IV/IO 0.1 units 100 units/mL Give over 10 min with glucose 10%.
glucose 10% IV/IO 5 mL Give over 10 min with insulin.
salbutamol nebulised 5 mg
sodium bicarbonate 8.4% IV/IO 1 mmol 1 mmol/1 mL Only if metabolic acidosis.
Give over 10 min.
Hypoglycaemia Dose Volume Comment collapse
glucose 10% IV/IO 2 mL Response should occur within 4-5 min.
Give oral carbohydrates once patient responsive.
Seizure Dose Volume Comment collapse
midazolam IV/IO, intramuscular 0.15 mg 5 mg/5 mL First line (except neonates).
Repeat once after 5 min if seizure ongoing.
phenytoin IV/IO load 250 mg/5 mL Second line.
Neat (preferred) or dilute with  mL sodium chloride 0.9%.
Give over 20 min.
levetiracetam Keppra IV/IO load 500 mg/5 mL Second line.
Dilute with  mL sodium chloride 0.9%. Give over 5 min.
phenobarbital IV/IO load 20 mg 200 mg/1 mL First line in neonates.
Dilute with  mL sodium chloride 0.9%. Give over 20 min.
midazolam infusion 3 mg 50 mg/10 mL Make up to 50 mL with sodium chloride 0.9%.
Titrate 2-18 mL/h (2-18 microg/kg/min).
Raised Intracranial Pressure Dose Volume Comment collapse
sodium chloride 3% IV/IO load 3 mL Give over 10 min.
Repeat once after 20 min if no effect.
mannitol 20% IV/IO load 0.5 g 100 g/500 mL Give over 20 min.
Repeat once after 30 min if no effect.
Overdose Dose Volume Comment collapse
naloxone IV/IO, intramuscular 10 microg 400 microg/1 mL Repeat as necessary (max total 2,000 microg).
Observe for at least 2 hours after last dose.
flumazenil IV/IO 5 microg 500 microg/5 mL Repeat every minute as necessary (max 5 doses).
Observe for several hours after last dose.
Acute Behavioural Disturbance Dose Volume Comment collapse
diazepam oral First line after unsuccessful verbal de-escalation. Max two doses.
Proceed to parenteral sedation if no effect in 45 min or behaviour escalates.
olanzapine wafer oral First line after unsuccessful verbal de-escalation. Single dose.
Proceed to parenteral sedation if no effect in 45 min or behaviour escalates.
droperidol intramuscular 2.5 mg/1 mL Second line after oral therapy.
Repeat dose after 15 min if necessary.
ketamine intramuscular 200 mg/2 mL Third line.
ketamine IV/IO 200 mg/2 mL Third line.
midazolam IV/IO 5 mg/5 mL Third line. Give up to 4 doses (max total  mg).
Analgesia Dose Volume Comment collapse
fentanyl intraNASAL 1.5 microg 100 microg/2 mL Administer with atomiser quickly, dividing dose between both nostrils.
Second dose if ongoing pain after 5 min, then consider IV route.
morphine IV/IO 10 mg/1 mL
paracetamol oral, IV/IO
ibuprofen oral 10 mg
Antiemetics Dose Volume Comment collapse
ondansetron oral Not recommended <8 kg.
ondansetron IV/IO
Antibiotics for Sepsis ? Source Dose Volume Comment collapse
benzylpenicillin IV/IO Recommended <1 month in combination with cefOTAXIME.
cefOTAXIME IV/IO 50 mg Recommended all ages in combination with either
benzylpencillin <1 month or flucloxacillin ≥1 month.
cefTRIAXONE IV/IO Alternative to cefOTAXIME ≥3 months.
flucloxacillin IV/IO Recommended ≥1 month in combination with either
cefOTAXIME (≥1 month), or cefTRIAXONE (≥3 months).
aciclovir IV/IO 250 mg/10 mL Dilute with  mL sodium chloride 0.9%.
Give over 60 min.
For suspected acute encephalitis: fever plus persisting altered conscious state.
Equipment collapse
Airway Size / Depth collapse
laryngoscope blade
bougie / stylet
ETT (endotracheal tube) diameter information
ETT oral depth
ETT nasal depth
suction catheter
LMA (laryngeal mask airway)
nasopharyngeal airway
Other Equipment Size collapse
naso/orogastric feeding tube
chest drain (air / effusion)
chest drain (trauma / blood)
indwelling urinary catheter
femoral central venous line
Observations Normal Range collapse
respiratory rate
heart rate
systolic blood pressure
Administration Route Colours
IV/IO stat or load
IV/IO infusion
other (ETT, intramuscular, intraNASAL, nebulised, oral)
Abbreviations
bpm beats or breaths per minute cm centimetres ECG electrocardiogram ED Emergency Department ETT endotracheal tube Fr French g grams h hours IO intraosseous IV intravenous J joules kg kilograms L litres max maximum mg milligrams microg micrograms min minutes mL millilitres mm millimetres mmHg millimetres of mercury mmol millimoles RHH Royal Hobart Hospital VBG venous blood gas
Disclaimer
This calculator has been designed to assist clinicians with weight based calculations in children. The calculator does not replace a medication prescription or clinical judgement. All drug calculations are based on established paediatric resuscitation resources (ARC & APLS) and protocols at the RHH ED. Please review your local protocols before prescribing these drugs. Please check all prescriptions and medications carefully as the author takes no responsibility for the accuracy of doses or calculations. The calculator is designed to be used in conjunction with an appropriate formulary which contains information on drug interactions, compatibilities, precautions, side effects, rates of delivery, maximum/minimum doses and drug monitoring.