Pediatric Dosages And Calculations

Question 1

Salbutamol for bronchodilation in asthma/anaphylaxis

Answer 1

Salbutamol - Nebulized

• Age < 1 year: 2.5 mg via nebulizer
• Age > 1 year: 5.0 mg via nebulizer

Salbutamol - MDI

• <10 kg: not indicated
• 10 - 20 kg: 5 x 100 mcg per round; repeat up to 3 rounds in total
• >20 kg: 10 x 100 mcg per round; repeat up to 3 rounds in total
  *

Question 2

Epinephrine in asthma refractory to bronchodilators

Answer 2

• 0.01 mg/kg IM 1:1000 (max 0.5 mg)

Question 3

Epinephrine for croup

Answer 3

• Administer 5 mg (5 ml) 1:1000 by nebulizer mask with an oxygen flow sufficient to aerosolize the medication
• Patients under 1 year of age receive a weight based dose, 0.5 mg/kg in 5 mL N/S; max 5 mg

Not for epiglottitis! Only Croup!

Question 4

Epinephrine for anaphylaxis

Answer 4

• 0.01 mg/kg IM (1:1000 - max 0.5 mg)
• 0.005mg/kg IV, MAX 0.3mg

Question 5

Epinephrine if there are obvious signs of hypo-perfusion in the context of respiratory distress

Answer 5

• 0.005 mg/kg IV (max 0.5 mg)

Question 6

Magnesium sulfate for bronchodilation

Answer 6

• 50 mg/kg over 20 mins (max 2 g)

Question 7

Describe an escalating pharmacological management strategy for a 16kg 3-year-old with acute asthma, progressing on scene from respiratory distress to imminent cardiovascular collapse.

Answer 7

• Salbutamol
  
  • 5x100mcg, repeat x3
• Epinephrine
  
  • 0.16mg 1:1000 IM
• Epinephrine
  
  • 0.08mg IV/IO
• Magnesium Sulfate
  
  • 800mg IV/IO over 20 minutes

Question 8

Ipratropium for respiratory distress

Answer 8

Trick Question! Not indicated in pediatrics!

Question 9

Formula for estimating weight of paediatric patients

Question 10

Formula for estimating minimum acceptable SBP for paediatric pts.

Question 11

Formula for estimating ETT sizes in pediatrics

Question 12

Ketamine induction dose in children

Question 13

Midazolam IM/IN for PSA or induction

Answer 13

0.2mg/kg (MAX 10kg)

Question 14

Midazolam IV/IO for PSA or induction

Answer 14

0.1mg/kg (MAX 5 mg)

Question 15

Defibrillator energy doses for children in cardiac arrest

Question 16

IV Epinephrine for children in cardiac arrest

Answer 16

0.01mg/kg q.3-5min (MAX 1mg single push)

Question 17

Epinephrine via ETT for children in cardiac arrest

Answer 17

0.1mg/kg q.3-5min (MAX 10mg)