Below is a rapid reference for essential information related to the care of pediatric patients including sizing estimates for endotracheal tubes and weight-based dosing for critical/common medications (rapid sequence intubation, pediatric advanced life support, seizure management), compiled by Dr. Kelly Young1.
Airway
- ETT
- 4 + Age/4 = uncuffed
- Subtract 0.5 for cuffed
- Gestational age (weeks) / 10 if premature
- Depth = ETTx3
- Blade
- Newborn: 0
- <2yo: 1
- 2-8yo: 2
- >8yo: 3
- Other Tubes
- NGT = ETT x 2
- Chest tube = ETT x 4
Estimating Weight
| Age (years) | 1 | 3 | 5 | 7 | 9 |
|---|---|---|---|---|---|
| Weight (kg) | 10 | 15 | 20 | 25 | 30 |
Vital Signs
Blood Pressure
| Age | Measure |
|---|---|
| Neonate | 60mmHg |
| <1yo | 70mmHg |
| 1-10yo | 70 + (Age x2) |
| >10yo | 90mmHg |
Heart/Respiratory Rate
| Age (yrs) | HR | RR |
|---|---|---|
| 0-1 | 140 | 40 |
| 1-4 | 120 | 30 |
| 4-12 | 100 | 20 |
| >12 | 80 | 15 |
Medications
| Name | Dose |
|---|---|
| RSI (Paralysis) | |
| Succinylcholine | 1mg/kg (x2 infant, x3 neonate) |
| Rocuronium | 1-1.2mg/kg |
| RSI (Sedation) | |
| Etomidate | 0.3mg/kg |
| Ketamine | 2mg/kg |
| Midazolam | 0.1mg/kg |
| Fentantyl | 1mcg/kg |
| PALS | |
| Defibrillation | 2, 4, 10J/kg |
| Cardioversion | 0.5, 1J/kg |
| Epinephrine | 0.01mg/kg (0.1mL/kg of 1:10,000) |
| Atropine | 0.02mg/kg (minimum dose 0.1mg, maximum 0.5mg) |
| Adenosine | 0.1mg/kg (max 6mg), 0.2 mg/kg (max 12mg) |
| Amiodarone | 5mg/kg |
| Calcium gluconate (10%) | 1mL/kg |
| Calcium chloride (10%) | 0.2mL/kg |
| Magnesium sulfate | 25mg/kg |
| Sodium bicarbonate | 1mEq/kg |
| 3% saline | 5cc/kg |
| Mannitol | 1g/kg |
| Fluids | |
| Normal saline (0.9%) | 20cc/kg |
| PRBC | 10cc/kg |
| Maintenance | 4cc/kg (first 10kg), 2cc/kg (second 10kg), 1cc/kg thereafter |
| Dextrose | |
| <1yo | D10, 5cc/kg |
| 1-10yo | D25, 2cc/kg |
| >10yo | D50, 1cc/kg |
| Anti-epileptics | |
| Lorazepam, Midazolam | 0.1mg/kg x3 |
| Fosphenytoin | 20 PE/kg |
| Keppra | 20-40mg/kg |
| Valproate | 20mg/kg |
| Phenobarbital | 20mg/kg |
| Midazolam infusion | 0.1mg/kg/h |
| Midazolam IN | 0.2mg/kg (max 10mg) |
| Antibiotics | |
| Ceftriaxone | 50mg/kg |
| Amoxicillin | 90mg/kg divided BID |
| Azithromycin | 10mg/kg day 1, 5mg/kg days 2-5 |
| Common Medications | |
| Acetaminophen | 15mg/kg |
| Ibuprofen | 10mg/kg |
| Diphenhydramine | 1.25mg/kg |
| Ondansetron | 0.15mg/kg |
| Intranasal Medications | |
| Fentanyl | 1.5mcg/kg (max 100mcg) |
| Midazolam | 0.5mg/kg (max 10mg) |
Reference:
- Young, K. D. (2016, April 18). Pediatric Doses and Sizes. Lecture presented at Harbor-UCLA Medical Center in CA, Torrance.