Pediatric Sizes and Doses

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

Reference:

  1. Young, K. D. (2016, April 18). Pediatric Doses and Sizes. Lecture presented at Harbor-UCLA Medical Center in CA, Torrance.