Home

Paed Drugs Calc

>5 years old 31kg

Emergencies (see individual guidelines)

  • WETFAG
  • Weight (>5 years old)
    (3 x age) + 7
    Energy
    4 J/kg
    ETT Size
    (age/4) + 4
    ETT Length
    (age/2)+12
    Fluid bolus (crystalloid)
    10-20 ml/kg
    Adrenaline
    10 mcg/kg
     
    = 0.1 ml/kg 1:10,000
    Atropine
    20 mcg/kg
    Dextrose 10%
    2 ml/kg
  • Anaphylaxis
  • Intravenous: for a periarrest situation draw up arrest dose of adrenaline (0.1 ml/kg () 1:10,000) and dilute to 10ml with saline (1 mcg/kg/ml ()).
    Use 0.5 - 1 ml () IV boluses to treat hypotension (with fluids as appropriate).
    IM Adrenaline 1:1000
    <6 years
     
    150 mcg (0.15 ml)
    6-12 years
     
    300 mcg (0.3 ml)
    >12 years
     
    500 mcg (0.5 ml)
    Chlorphenamine
    <6 months
    250 mcg/kg
     
    <6 years
     
    2.5 mg
    6-12 years
     
    5 mg
    >12 years
     
    10 mg
    Hydrocortisone
    <6 months
     
    25 mg
    <6 years
     
    50 mcg (0.15 ml)
    6-12 years
     
    100 mcg (0.3 ml)
    >12 years
     
    200 mcg (0.5 ml)
  • Local Anaesthetic Toxicity
  • Intralipid Bolus
    1.5 ml/kg over 1 min
    Intralipid Infusion
    15 ml/kg/h
  • Malignant Hypothermia
  • Dantrolene
    2.5 mg/kg

Anaesthetic Drugs

  • Induction Agents
  • Propofol
    3-5 mg/kg
     
    Thiopentone
    3-5 mg/kg
     
    Ketamine
    1-2 mg/kg
     
  • Muscle Relaxants
  • Suxamethonium
    1-2 mg/kg
     
    Rocuronium
    0.6 mg/kg
     
    Rocuronium RSI
    0.9 mg/kg
     
    Atracurium
    0.5 mg/kg
     
    Mivacurium
    0.2 mg/kg
     
  • Opiates
  • Fentanyl
    1-3 mg/kg
     
    Morphine
    0.1 mg/kg
     
  • Reversal Agents
  • Neostigmine/Glyc
    0.02 ml/kg
     
    Sugammadex
    16 mg/kg
     
  • Antimuscurinics
  • Atropine
    20 mcg/kg
     
    Glycopyrrolate
    10 mcg/kg
     
  • Local Anaesthetics
  • Lignocaine
    3 mg/kg
     
     
    1%
     
     
    2%
     
    Lignocaine+adrenaline
    7 mg/kg
     
     
    1%
     
     
    2%
     
    Levobupivacaine
    2 mg/kg
     
     
    10 mg/ml (1%)
     
     
    20 mg/kg (2%)
     

Analgesia

  • QParacetamol
  • Oral
    Loading
    20-30 mg/kg
     
    Then
    15-20 mg/kg 4-6 hrly
     
    Max
    75 mg/kg/day
     
    Rectal
    Loading
    30-40 mg/kg
     
    Then
    15-20 mg/kg 4-6 hourly
     
    Max
    75 mg/kg/day
     
    Intravenous
    Dose
    15 mg/kg 4-6 hrly
     
    Then
    60 mg/kg/day
     
  • QDiclofenac
  • Oral
    Dose
    1 mg/kg 8 hrly
     
    Max
    3 mg/kg/day
     
    Rectal
    Dose
    1 mg/kg 8hrly
     
    or 
    2 mg/kg 16 hrly
     
    Max
    3 mg/kg/day
     
  • QIbuprofen
  • Oral
    Dose
    5-7.5 mg/kg 6 hrly
     
    Max
    30 mg/kg/day
     
  • Tramadol
  • Oral
    Dose
    50-100 mg 4-6 hrly
    50-100 mg 4-6 hrly
    Max
    400 mg/day
    400 mg/day
  • Fentanyl
  • Intravenous boluses
     
    Flowchart
    Fentanyl graphic
  • Morphine
  • Oral
    Dose
    200-400 mcg/kg 4-6 hrly
     
    Intravenous
    Dose
    50 mcg/kg bolus over 2 mins
     
    Max
    200 mcg/kg 2 hrly
     
    • A registered nurse must remain with child for 20 minutes after bolus.
    • Respiratory rate must be noted every 5 minutes for 20 minutes.
    • Full observations every 15 minutes.
    • Write up prn Naloxone 4 mcg/kg ( ).
    Infusion
    Mix
    0.5 mg/kg made up to 50ml in 0.9% Saline (10 mcg/kg/ml)
     
    Rate
    1-4 ml/hr (10-40 mcg/kg/hr)
     
    • A dedicated giving set with antireflux and antisiphon valves must be used.
    • Adequate IV loading doses of Morphine must be given prior to infusion.
    • Refer to pain guidelines (Appendix E) about observations and actions.
    • If rate is increased, observations revert to 15 minutes for 1 hour.
    • All children < 1 year must have continuous apnoea monitoring and SpO2.
    • Write up prn Naloxone 4 mcg/kg ( ).
  • QDiamorphine
  • Intranasal
    Dose is 100 mcg/kg () bolus over 2 minutes. Volume is always 0.2 ml.
    • Explain procedure to child and family.
    • Mix diamorphine 5mg in ml NaCl ( mg/ml)
    • Draw up solution with 1 ml syringe and then discard solution until only 0.2 ml () is left in syringe.
    • Gently tilt child backwards and put a couple of drops at a time into each nostril. 0.2 ml is approximately 8-10 drops.
    • Ask the child to sniff hard. The child will probably sneeze.
  • Naloxone
  • Intravenous
    Dose
    4 mcg/kg
     
    Repeat every 2 minutes if no response observed.
    For respiratory depression:
    < 3 years: rate < 15/minute.
    > 3 years: rate < 10/minute.

Antiemetics

  • QCyclizine
  • Oral/Intravenous
    Dose
    <12y - 1 mg/kg 8hrly
     
    Max
    50mg
     
  • QOndansetron
  • Oral/Intravenous
    Dose
    <12y - 100-150 mcg/kg 8hrly
     
    Max
    4 mg 8hrly
     
  • QDexamethasone
  • Intravenous
    Dose
    <12y - 100-150 mcg/kg
     
    Max
    8 mg
    8 mg

Antibiotics

  • Flucloxacillin
  • Orthopaedic Prophylaxis
    IV
    25 mg/kg (max 1g)
     
  • Teicoplanin
  • Orthopaedic Prophylaxis
    IV
    10 mg/kg (max 400mg)
     
    • Doses are from Greater Glasgow and Clyde paediatric guidelines.
    • Current general Orthopaedic guidelines suggests 400mg in adults independent of weight.
    • Current spinal guideline use 6 mg/kg () in adults, with a maximum of 600mg.
    • Slow to achieve adequate tissue levels, so requires very early administration, especially if tourniquet is used
    • Long half-life
    • If surgery prolonged do not repeat dose.
  • Gentamicin
  • Orthopaedic prophylaxis
    IV
    2 mg/kg
     
    Urology & Spinal Prophylaxis
    IV
    3 mg/kg
     
    Treatment
    IV
    5 mg/kg
     
    • Doses are based on Ideal Body Weight (IBW) so which will need calculating and dose subsequently reduced.
    • Reduce dose in renal impairment.
  • Coamoxiclav
  • Prophylaxic dose
    IV
    30 mg/kg (max 1.2g)
     
  • Cefuroxime
  • Prophylaxic dose
    IV
    50 mg/kg (max 1.5g)
     
  • Amoxycillin
  • Treatment
    IV
    50 mg/kg
     
  • Clindamycin
  • Orthopaedic Prophylaxis
    IV
    5 mg/kg (max 300mg)
     
    • Infused over 15 minutes.
    • Doses are from Greater Glasgow and Clyde paediatric guidelines.
    • If surgery prolonged repeat after 4 hours.
  • Metronidazole
  • Treatment
    IV
    7.5 mg/kg
     

Other

  • Midazolam Premedication
  • Oral
    500 mcg/kg (max 20mg)
     
    • 15-30 minutes pre-procedure.
  • Diazepam
  • Oral
    0.2-0.3 mg/kg 8hrly
     
    IV
    0.1-0.2 mg/kg
     
    • Treats muscle spasm.
    • Beware sedation and CVS depression.
  • Baclofen
  • Oral
    1-10y - 0.75-2 mg/kg daily
     
    Oral
    10-18y - 5mg tds increased gradually to max 2.5 mg/kg
     
    • Treats muscle spasm and chronic spasticity.

About

  • Paediatric Dose Calculator

  • Paediatric Dose Calculator is an amalgamation of the Paediatric Pain Guideline (written by Mike Walburn and Rachel Brown) and the Paediatric checklist.

    Sliding the age will change the weight using the WETFAG formula depending on age. If less than 1 year, a month slider will appear.

    Although I have tried checked this, it is possible there are some bugs, so do not take everything as gospel.

    Let me know if you find any problems.

     

    © Ian Sidwell May 2017. Updated April 2019.

Paracetamol
Diclofenac
Ibuprofen
Diamorphine
Cyclizine
Ondansetron
Dexamethasone
MRN:
NHS No:
Surname:
First Name(s):
D.O.B.:
Address:



Gender: M / F
Age:
Weight:
EMERGENCIES / DRUGS
Check following guidelines are available
DAS (airtrach/cricothyroidotomy)
APLS/cardiac arrest
Anaphylaxis
Local Anaesthetic toxicity
Malignant hyperthermia
Anaesthetic Drugs
Induction Agents
Propofol
3-5 mg/kg
mg
Thiopentone
3-5 mg/kg
mg
Ketamine
1-2 mg/kg
mg
Muscle Relaxants
Suxamethonium
1-2 mg/kg
 
Rocuronium
0.6 mg/kg
 
Rocuronium RSI
0.9 mg/kg
 
Atracurium
0.5 mg/kg
 
Mivacurium
2 mg/kg
 
Opiates
Fentanyl
1-3 mg/kg
 
Morphine IV
0.1 mg/kg
 
Reversal Agents
Neostigmine/Glyc
0.02 ml/kg
 
Sugammadex
16 mg/kg
 
Antimuscurinics
Atropine
20 mcg/kg
 
Glycopyrrolate
10 mcg/kg
 
Local Anaesthetics
Lignocaine
3 mg/kg
 
 
1%
 
 
2%
 
Lignocaine
7 mg/kg
 
 +adrenaline
1%
 
 
2%
 
Levobupivacaine
2 mg/kg
 
 
10 mg/ml (1%)
 
 
20 mg/kg (2%)
 
Cardiac Arrest
Weight
(2 x years) + 8
Energy
4 J/kg
ETT Size
(age/4) + 4
ETT Length
(age/2)+12
Fluid bolus (crystalloid)
10-20 ml/kg
Adrenaline
10 mcg/kg
 
= 0.1 ml/kg 1:10,000
Atropine
20 mcg/kg
Dextrose 10%
2 ml/kg
Anaphylaxis
Intravenous: for a periarrest situation draw up arrest dose of adrenaline (0.1 ml/kg () 1:10,000) and dilute to 10ml with saline (1 mcg/kg/ml ()).
Use 0.5 - 1 ml () IV boluses to treat hypotension (with fluids as appropriate).
IM Adrenaline 1:1000
<6 years
 
150 mcg (0.15 ml)
6-12 years
 
300 mcg (0.3 ml)
>12 years
 
500 mcg (0.5 ml)
Chlorphenamine
<6 months
250 mcg/kg
 
<6 years
 
2.5 mg
6-12 years
 
5 mg
>12 years
 
10 mg
Hydrocortisone
<6 months
 
25 mg
<6 years
 
50 mcg (0.15 ml)
6-12 years
 
100 mcg (0.3 ml)
>12 years
 
200 mcg (0.5 ml)
Local Anaesthetic Toxicity*
Intralipid Bolus
1.5 ml/kg over 1 min
Intralipid Infusion
15 ml/kg/h
Malignant Hyperthermia*
Dantrolene
2.5 mg/kg
* see individual guidelines.
MRN:
NHS No:
Surname:
First Name(s):
D.O.B.:
Address:



Gender: M / F
Age:
Weight:
ANAESTHETIC PLAN FOR CHILDREN
INDUCTION
IV / Inhalational Chair / Bed / Trolley
Special requirements*:


e.g. communication difficulties, anxieties, social issues
AIRWAY
Plan A:  
Plan B:  
LMA Type: Normal / Flexi / Proseal Size:
ETT Type: Cuffed / Uncuffed:
ETT Size (age / 4 + 4): Length (age / 2 + 12):
Difficult airway equipment required? Y / N
Check!
Facemask / filter

Guedel

Yankheur sucker

ETT ±1 size

Bougie / stylet

Laryngoscopes x2

ETT suction catheters
BREATHING
Ventilation: SV / IPPV
Tidal volume for IPPV*:            ml
Anaesthetic room circuit: T-Piece / Bain
Theatre Circuit: T-Piece / Paed circle / Adult circle
Check appropriately sized!
Self-inflating bag

Guedel

SpO2 probe

*tidal volume usually (cc), but in smaller children take into account anaesthetic circuit compliance and use CO2 / chest rise as a guide
CIRCULATION
IV fluid - type:  
Bolus volume* (10-20ml/kg):
Giving set: Burette / Pump / Standard giving set
Theatre Circuit: T-Piece / Paed circle / Adult circle
Check appropriately sized!
Range of cannulae ± 24G
extension set
*maintenance requirement (ml/hr)
- first 10kg 4ml/kg/hr
- second 10kg 2ml/kg/hr
- remaining 1ml/kg/hr
REGIONAL ANAESTHESIA
Type of block:
Drug: Concentration: Volume:            ml
Equipment required:
TEMPERATURE
Type of blanket: Normal / Underwarmer / Overwarmer
Type of monitor: Ear / Skin / Nasal / Oral / Rectal
Check appropriate!
Theatre temperature

Back About