USEFUL PAEDIATRIC

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Appendix 2

USEFUL PAEDIATRIC

DRUG DOSES

(1) Direct Current (DC) Defibrillation for cardiac arrest/pulseless states:

- for VF and pulseless VT
start at 2 Joules/kg, try twice then increase to 4 J/kg (unsynchronised mode)

- for SVT
0.5 – 1 J/kg (synchronised mode)

                    (2) Adrenalin for cardiac arrest – IV or IO^* bolus:
                            Make up 1mg into 10ml with isotonic saline (100 microgram(µg)/ml);
                            Give 10 µg/kg IV or IO^* initially, up to 100 µg/kg subsequently.
                            Endotracheal^** doses are up to 100 µg/kg.

                    (3) Adrenalin for cardiac arrest – IV infusion:
                            Make up 1mg into 1000ml isotonic saline (1 µg/ml);
                            Give a continuous venous infusion of approximately 0.1-1 µg/kg per min

          (4) Lignocaine for VF, VT, ventricular ectopy:
                  Initially 1 mg/kg IV or IO or via ETT^**;
                  Subsequent infusion (suppress ventricular ectopy) 20-50 µg/kg

(5) Atropine for cardiac arrest or bradycardia:
20 µg/kg IV or IO^* or via ETT^**

          (6) Suxamethonium for intubation:
                 1-2 mg/kg; 2 mg/kg in infants
                 - may be given IV or infra-lingually by submucous injection in the absence of IV access

          (7) Salbutamol for nebulisation:
                 1 year – 1.25 mg
                 5-10 years – 2.5mg

          (8) Other indications for adrenalin:
                Severe bradycardia (with or without hypotension)
                Anaphylaxis
                Severe bronchospasm

* IO = intra-osseus

** The endotracheal route in children is an alternative for administration of adrenaline, atropine and lignocaine,
if intravenous (IV) or intra-osseous (IO) access is not available.