Paediatric Dosages Flashcards
Adrenaline Indications
Cardiac Arrest
Anaphylaxis or severe allergic reaction
Seere life-threatening bronchospasm OR silent chest (only able to speak in single works AND/OR silent chest AND/OR haemodynamic compromise AND/OR an ALOC)
Bradycardia with poor perfusion (unresponsive to atropine AND/OR TCP)
Croup (with stridor at rest)
Shock unresponsive to adequate fluid resuscitation (excluding haemorhagic cause)
Adrenaline Dosages
Anaphylaxis OR severe allergic reaction
IM - ACP1, ACP2, CCP
≥ 6 years - 300 microg
repeat at 5 minute intervals. No max dose
< 6 years - 150 microg
Repeat at 5 minute intervals. No max dose.
IV/IO - CCP
2 microg/kg (Single dose not to excede 50 microg)
Repeat at 2 minute intervals. No max dose.
NEB - ACP2, CCP
5mg Single dose only
Adrenaline Dosages
Severe life-threatening bronchospasm OR silent chest
IM - ACP1, ACP2, CCP
≥ 6 years - 300 microg
repeat at 5 minute intervals. No max dose
< 6 years - 150 microg
Repeat at 5 minute intervals. No max dose.
IV/IO - CCP
2 microg/kg (Single dose not to excede 50 microg)
Repeat at 2 minute intervals. No max dose.
Adrenaline Dosages
Cardiac Arrest
IV - ACP2, CCP
≥ 10kg (≥ 1 year) - 10microg/kg
Repeat at 3-5 minute intervals. No max dose.
<10kg (<1 year) - 100 microg
Repeat at 3-5 minute intervals. No max dose.
Adrenaline Dosages
Croup
NEB - ACP2, CCP
5mg. Single Dose only.
Adrenaline Dosages
Shock Unresponsive to adequate fluid resus
IV/IO - CCP
2 microg/kg (Single dose not to excede 50 microg)
Repeat at 2 min intervals. No max dose.
Adrenaline Dosages
Bradycardia with poor perfusion
CONSULT!
Amiodarone Paediatric Indications
Cardiac arrest (refractory VF or pulse-less VT)
Amiodarone Dosages
Cardiac Arrest
IV/IO
5mg/kg
Slow push over 2 minutes
Single dose only
Atropine Indications
Bradycardia (with poor perfusion)
Envenomation (with increased parasympathetic activity)
Hypersalivation (secondary to ketamine administration)
Organophosphate toxicity (with cardiac AND/OR respiratory compromise)
Atropine Dosages
Bradycardia
IV/IO - CCP
20 microg/kg (Single dose not to exceed 600 microg)
Repeat ONCE at 2 minutes.
Total max dose 40 microg/kg
Atropine Dosages
Envenomation and Organophosphate toxicity
IM/IV/IO - ECP, CCP (IO CCP only)
20 microg/kg (Single dose not to exceed 600 microg)
Repeat at 5 minute intervals. No Max dose.
Atropine Dosages
Hypersalivation
IV - CCP
20 microg/kg (single dose not to exceed 600 microg)
Single dose only
Calcium Gluconate Paediatric Indications
Suspected Hyperkalaemic cardiac arrest
Severe Hyperkalaemia
Calcium Gluconate Blocker toxicity
Hypotension associated with Magnesium infusion (that fails to respond to IV fluid therapy)
Calcium Gluconate Dosages
All indications
IV/IO - CCP
0.5 mL/kg (or 50 mg/kg)
Slow push over 2-5 minutes.
Repeated once at 10 minutes.
Ceftriaxone Indications
Suspected meningococal septicaemia (with a non-blanching petechial and/or purpuric rash)
Ceftriaxone Dosages
IM - ACP1, ACP2, CCP
50 mg/kg (rounded up to the nearest 5kg)
Reconstitute in 3.6mL water for ingection.
IV/IO - ACP2, CCP (IO CCP ONLY)
50 mg/kg (rounded up to the nearest 5kg)
Reconstitute in 9.6mL water for ingection.
Fentanyl Indications
Significant Pain
Sedation (for maintenance of established ETT)
Fentanyl Dosages
Significant Pain
NAS - ACP2, CCP
≥ 1 year (CCP 6 months) - 1.5 microg/kg
Repeat at 1 microg/kg at 10 minutes.
< 1 year (CCP 6 months) - CONSULT
IM - ACP2, CCP ≥ 1 year - 1-2 microg/kg (CCP 2 microg) Single max dose 50 microg Total max dose 2 microg/kg < 1 year - CONSULT
IV - ACP2, CCP
≥ 1 year - 1microg/kg
Single max dose 25 microg
Repeat at 0.5 microg/kg (max 25 microg) at 5 minutes.
Total max dose 2 microg/kg. (CCP - no max dose)
< 1 year - CONSULT
Fentanyl Dosages
Sedation
IV/IO - CCP ≥ 1 year - 1 microg/kg Single max dose 25 microg Consider administration with midazolam. No max dose. <1 year - Consult
Glucagon Indications
Symptomatic hypoglycaemia (with inability to self-administer oral glucose)
Glucagon Dosages
> 25 kg - 1 mg single dose only.
≤ 25 kg - 0.5 mg single dose only.
Glucose 10% Indications
Symptomatic hypoglycaemia (with inability to self-administer oral glucose)
Glucose 10% Dosages
IV/IO - ACP2, CCP (IO CCP only)
0.25 g/kg (2.5mL/kg)
Repeat at 1mL/kg boluses every 5 minutes until BGL < 4.0 mmol/L
Glucose gel Indications
Symptomatic hypoglycaemia (with ability to self-administer oral glucose)
Glucose Gel Dosages
PO - ACP1, ACP2, CCP
≥ 2 years - 15g
Repeat once at 15 minutes if BGL <4 mmol/L
Total max dose 30g
Glyceryl Trinitrate Paediatric Indications
Autonomic Dysreflexia (SBP > 160 mmHg) Irukandji Syndrome (SBP > 160 mmHg)
GTN Dosages
All inidcations
Sublingual - ACP2, CCP
CONSULT
Hydrocortisone Indications
Moderate or Severe Asthma
Severe allergic reaction OR anaphylaxis (requiring adrenaline (epinepherine) administration)
Symptomatic adrenal insufficiency
Hydrocortisone Dosages
Moderate or Severe Asthma
Severe allergic reaction OR anaphylaxis
IM/IV - ECP (with consult), CCP
5mg/kg Single dose only. Not to exceed 100mg)
IV single dose only
Ipratropium Bromide Indications
Moderate OR severe bronchospasm
Ipratropium Bromide Dosages
NEB - ACP1, ACP2, CCP
≥ 2 years - 250 microg. Single dose
Ketamine Paediatric Indications
- Severe traumatic pain (following 0.2mg-0.2mg/kg morphne or 1-2 microg/kg fentanyl) associated with:
- fracture reduction and splinting
- multiple or significant fractures requiring facilitated extrication
- Patients with splinted fractures requirign ongoing narcortic analgesia for transport requirements)
Induction of anasethesia
- Severe traumatic pain associated with burns
- Ongoing traumatic pain unresponsive to narcotics (following 0.2-0.3 mg/kg morphine OR 2-3 microg/kg fentanyl)
Ketamine Dosages
Severe traumatic pain associated with burns
IV - CCP
CONSULT
Ketamine Dosages
Ongoing traumatic pain
Severe traumatic pain
IV - CCP
> 1 year - 100microg/kg (0.1mg/kg)
Repeate every 2-3 minutes
Total max dose 1mg/kg
Ketamine Dosages
Induction of anaesthesia
IV/IO - ECCP
0.25-2mg/kg
Single dose only
Total max dose 100mg
Magnesium Sulphate Indications
Irukandji Syndrome
Sever Life-threatening asthma
Torsades de Pointes
Box jellyfish envenomation
Magnesium Sulphate Dosages
Irukandji syndrome and Box jellyfish envenomation
IV - E.ACP2, CCP
0.1 mmol/kg over 15 minutes (rounded p to nearest 0.5 mmol). Single max dose 5 mmol
Repeat once at 10 minutes
Total max 10 mmol.
Magnesium Sulphate Dosages
Torsades de Pointes
IV/IO - CCP 0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol) Single dose not to exceed 5 mmol Repeat once at 10 minutes Total max dose 10 mmol
Magnesium Sulphate Dosages
Severe life-threatening asthma
IV/IO - CCP
0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol)
Single dose not to exceed 5 mmol
Midazolam Indications
Generalized seizures/focal seizures (GCS < 12)
Sedation
Acuute behavioural disturbance (with SAT score at 2 or >)
Midazolam Dosages
Generalized Seizures/focal seizures
NAS - ACP2, CCP 200 microg/kg Single dose not to exceed 5mg. Repeat at half the initial dose at 10 minutes (max 0.25mg) Total Max 10mg
IM - ACP2, CCP 200 microg/kg Single dose not to exceed 5mg. Repeat at half the initial dose at 10 minutes (max 0.25mg) Total Max 10mg
IV/IO - CCP 100mcg/kg Single dose not to exceed 2.5mg Repeat at 5 min intervals Total max dose 10mg
Midazolam Dosages
Sedation
IV/IO - CCP Up to 100 microg/kg Single dose not to exceed 2.5mg Repeat at 3-5 minute intervals Total max dose 5mg
Midazolam Dosages
Acute Behavioural disurbance
IM (only if IV access not acheiveable)
≥ 8 years - 200 microg/kg
Single dose only. Max 5mg
IV - CCP
≥ 8 years - 100 microg/kg
Single dose only. Max 2.5mg
Naloxone Indications
Respiratory depression (secondary to administration of narcotic drugs)
Naloxone Dosages
IM - ACP2, CCP
20 microg/kg
Single dose only. Not toe xceed 800 microg.
Ondansetron Indications
Nausea AND/Or vomiting
Ondansetron Dosages
IM - ACP1
≥ 5 years - 2mg
Single dose only
IM - ACP2, CCP
≥ 3 years - 100 microg/kg
single dose only, not to exceed 4mg
IV - ACP2, CCP
≥ 3 years - 100 microg/kg
single dose only, not to exceed 4mg
Slow push over 2-3 minutes
Paracetamol Indications
Minor pain
Fever (causing distress)
Paracetamol Dosages
PO - ACP1, ACP2, CCP
≥ 1 month - 15mg/kg
Single dose only
Promethazine Paediatric Indications
Symptomatic rash/moderate allergic reactions
Promethazine Dosages
IV - ECP (CONSULT), CCP
≥ 2 years - 250 microg/kg
Single dose only. Not to exceed 12.5mg
Slow push over 1 minutes
Salbutamol Indications
Bronchospams Suspected hyperkalaemia (with QRS widening AND/OR dissociation)
Salbutamol Dosages
Bronchospasm
NEB - ACP1, ACP2, CCP
≥ 2 years - 5mg
Repeated PRN
No max dose
IV - CCP
≥ 2 years - 5microg/kg
Single dose not to exceed 250 microg.
Repeat once at 10 mintues
Salbutamol Dosages
Suspected hyperkalaemia
NEB - CCP
5mg - Single dose only
Sodium Bicarbonate Paediatric Indications
Cardiac Arrest
Suspected hyperkalaemia
Significant injury with potential for crush injury
Sodium Bicarbonate Dosages
All indicatiosn
IV/IO - ECP, CCP (IO CCP only)
1mL/kg - Single Dose only
ECP must Consult