Pediatric Code Meds

General Code Meds

Allergy
Analgesia
Asthma/Croup
Drips
Hyperkalemia
Hypocoagulation
Hypertension
Hypoglycemia
Ingestion
Intubation
Meningitis/Sepsis
Sedation
Seizures/Increased ICP

General Code Meds:

Drug Dose Route

Epinephrine 0.01 mg/kg (1:10000) IM IV IO

Epinephrine 0.1 mg/kg (1:1000) (ET)

Atropine 0.02 mg/kg
min: 0.1 mg/dose;
max 0.5 mg/dose child
max 1 mg/dose adolescent IM IV ET IO

Bretylium 5-10 mg/kg IV IO

Bicarbonate 1-2 mEq/kg IV IO

CaCl2 10-20 mg/kg Central IV, IO

Calcium gluconate 30-60 mg/kg IV IO

25% dextrose 2-4 cc/kg IV IO

10% dextrose 5-10 cc/kg IV IO

Diazepam 0.1-0.3 mg/kg IV IO

3% NaCl 2 cc/kg IV IO

Lidocaine 1 mgkg IV IO

Naloxone 0.1 mg/kg IV IM ET IO

Drips

Dopamine 2 - 20 mcg/kg/min

Dobutamine 2 - 20 mcg/kg/min

Epinephrine 0.05 - 2 mcg/kg/min

Isoproterenol 0.05 - 2 mcg/kg/min

Nitroprusside 0.2 - 5 mcg/kg/min

Lidocaine 20 - 50 mcg/kg/min

Prostaglandin E1 0.05 - 2 mcg/kg/min

Allergy

Epinephrine 0.01cc/kg SC 1:1000 (max 0.3cc)

Diphenhydramine 1-2 mg/kg IV

Hydrocortisone 1-2 mg IV

Analgesia

Acetaminophen 10-15 mg/kg/dose q 4-6 hours

Codeine 0.5-1 mg/kg/dose IM SC PO q 4-6 hours

Fentanyl 1-2 mcg/kg/dose IV IM q 1-2 hours

Ketorolac Load 1 mg/kg (max 30 kg)
Maintain at 0.5 mg/kg/dose q 6 hours, no more than 5 days
Adult dose = 60 mg load, then 30 mg q 6 hours

Meperedine 1-1.5 mg/kg/dose q 3-4 hours PO, IM, IV, SC

Morphine 0.05-0.2 mg/kg IV q 2-4 hours (max 15 mg)

Asthma/Croup

Nebulized Solutions

Solution Formulation < 10 kg 10-20 kg > 20 kg

Albuterol 0.5% 0.15 cc 0.25-0.5 cc 0.75 cc

Alupent 0.5% 0.10 cc 0.20 cc 0.30 cc

Terbutaline 0.1% 0.25 cc 0.5 cc 1.0 cc

Racemic Epi 2.0% 0.25 cc 0.50 cc 0.75 cc

Nebulize above solutions in 3 cc NS

Continuous Nebs 0.15-0.5 mg/kg/hour of Albuterol or Terbutaline

Aminophylline Load with 5-8 mg/kg IV followed by 1.0 mg/kg IV drip and titrate for approximate levels (10-20)

Solumedrol 1-2 mg/kg IV bolus followed by 1-2 mg/kg/dose

Atropine 0.05 mg/kg/dose neb (max 1 mg)

Epinephrine (1:1000) 0.01 mg/kg SC (max 0.3 cc)

Terbutaline 0.01 mg/kg/dose SC or 0.03 mg/kg/dose (max 0.4 mg) NEB

IV Terbutaline load 10 mcg/kg (5 minutes) then 0.4 mcg/kg/min

Hypocoagulation

FFP 10 cc/kg IV to restore coagulation

Protamine For heparin reversal: 1mg for q 100 Units heparin (max 50 mg)

Vitamin K For coumadin OD: 1-2 mg/dose IM SC q 4-8 or FFP as above

Cryoprecipitate 10 cc/kg IV (provides fibrinogen as well as factors)

Hypoglycemia (consider drawing blood for insulin, glucagon and GH levels)

Dextrose 2-3 cc/kg D25 IV or 5-10 cc (0.5 - 1 cc/gk) of D10

Glucagon 0.1 mg/kg IM IV SC q 30 min (max 1 mg)

Hyperkalemia

NaHCO3 1-3 mEq/kg IV over 3-5 minutes

Calcium Gluconate (10%) 0.2-0.5 cc/kg IV over 2-5 minutes

Glucose 0.5 g/kg (1cc of D50/kg or equivalent) with 0.3 units insulin per gram glucose IV over 1-2 hours

Kayexelate 1-2 g/kg/dose with 3 cc sorbitol/g q 6 hours PO (or PR q 4-6 hours)

Hypertension

Diazoxide 3-5 mg/kg/dose IV FAST q 5-15 minutes x 2-3 doses

Labetalol 1-3 mg/kg/hr IV drip

Nifedipine 0.25 - 0.5 mg/kg/dose PO

Nitroprusside 0.5-10 mg/kg/min IV drip

Phentolamine 0.1-0.2 mg/kg IV (pheochromocytoma)

Ingestion

Charcoal 0.5-1 g/kg 1:40 with 70% sorbitol PO/NG

Ipecac Syrup

< 1 yr 10 cc

1-12 yr 15-30 cc

> 12 yr 30-60 cc

q20 minutes x 2, not for caustics

Intubation

Atropine 0.01-0.02 mg/kg

Midazolam 0.1 - 0.3 mg/kg

Ketamine 1-2 mg/kg

Fentanyl 5 mcg/kg

Thiopental 2-4 mg/kg

Etomidate

Succinylcholine 1-2 mg/kg

Atracurium 0.5 mg/kg

Vecuronium 0.3 mg/kg

Pancuronium 0.1-0.2 mg/kg

Rocuronium

Meningitis/Sepsis

Ampicillin 200-400 mg/kg/day div q4-6h (max 2-4 g/d)

Cefotaxime 150 mg/kg/day div q8h

Ceftriaxone 100 mg/kg/day div q 24h (max 4g/d)

Decadron 0.15 mg/kg/dose IV q 6 hours x 4 days (prior to abx if possible)

Gentamicin 2.5 mg/kg/dose q 8 hours (pk 6-10, tr < 2)

Vancomycin 10-15 mg/kg/dose IV q 8-24h (pk 25-40, tr <10)

Sedation

Chloral Hydrate 50-100 mg/kg PO/PR max 2 grams

Diazepam 0.05-0.2 mg/kg/dose IV

Ketamine 0.5-1 mg/kg IV or 3-7 mg/kg IM

Midazolam 0.05-0.2 mg/kg/dose IV

Thiopental 2-4 mg/kg IV

Seizures/Increased ICP

Diazepam 0.05-0.2 mg/kg/dose IM or IV

Midazolam 0.05-0.2 mg/kg/dose IM or IV

Phenytoin 15-20 mg/kg/dose IV (max 1g/24 hours)

Lorazepam 0.05-0,1 mg/kg/dose IV q15-20 minutes

Mannitol 0.25-1 g/kg IV q 5 minutes

Decadron 0.5-1.0 mg/kg IV

Emergency Pediatrics

NetScut Home

Please direct all comments to:

Last modification: September 27, 1998

Drug	Dose	Route
Epinephrine	0.01 mg/kg (1:10000)	IM IV IO
Epinephrine	0.1 mg/kg (1:1000)	(ET)
Atropine	0.02 mg/kg min: 0.1 mg/dose; max 0.5 mg/dose child max 1 mg/dose adolescent	IM IV ET IO
Bretylium	5-10 mg/kg	IV IO
Bicarbonate	1-2 mEq/kg	IV IO
CaCl2	10-20 mg/kg	Central IV, IO
Calcium gluconate	30-60 mg/kg	IV IO
25% dextrose	2-4 cc/kg	IV IO
10% dextrose	5-10 cc/kg	IV IO
Diazepam	0.1-0.3 mg/kg	IV IO
3% NaCl	2 cc/kg	IV IO
Lidocaine	1 mgkg	IV IO
Naloxone	0.1 mg/kg	IV IM ET IO

Dopamine	2 - 20 mcg/kg/min
Dobutamine	2 - 20 mcg/kg/min
Epinephrine	0.05 - 2 mcg/kg/min
Isoproterenol	0.05 - 2 mcg/kg/min
Nitroprusside	0.2 - 5 mcg/kg/min
Lidocaine	20 - 50 mcg/kg/min
Prostaglandin E1	0.05 - 2 mcg/kg/min

Epinephrine	0.01cc/kg SC 1:1000 (max 0.3cc)
Diphenhydramine	1-2 mg/kg IV
Hydrocortisone	1-2 mg IV

Acetaminophen	10-15 mg/kg/dose q 4-6 hours
Codeine	0.5-1 mg/kg/dose IM SC PO q 4-6 hours
Fentanyl	1-2 mcg/kg/dose IV IM q 1-2 hours
Ketorolac	Load 1 mg/kg (max 30 kg) Maintain at 0.5 mg/kg/dose q 6 hours, no more than 5 days Adult dose = 60 mg load, then 30 mg q 6 hours
Meperedine	1-1.5 mg/kg/dose q 3-4 hours PO, IM, IV, SC
Morphine	0.05-0.2 mg/kg IV q 2-4 hours (max 15 mg)

FFP	10 cc/kg IV to restore coagulation
Protamine	For heparin reversal: 1mg for q 100 Units heparin (max 50 mg)
Vitamin K	For coumadin OD: 1-2 mg/dose IM SC q 4-8 or FFP as above
Cryoprecipitate	10 cc/kg IV (provides fibrinogen as well as factors)

Dextrose	2-3 cc/kg D25 IV or 5-10 cc (0.5 - 1 cc/gk) of D10
Glucagon	0.1 mg/kg IM IV SC q 30 min (max 1 mg)

NaHCO3	1-3 mEq/kg IV over 3-5 minutes
Calcium Gluconate	(10%) 0.2-0.5 cc/kg IV over 2-5 minutes
Glucose	0.5 g/kg (1cc of D50/kg or equivalent) with 0.3 units insulin per gram glucose IV over 1-2 hours
Kayexelate	1-2 g/kg/dose with 3 cc sorbitol/g q 6 hours PO (or PR q 4-6 hours)

Diazoxide	3-5 mg/kg/dose IV FAST q 5-15 minutes x 2-3 doses
Labetalol	1-3 mg/kg/hr IV drip
Nifedipine	0.25 - 0.5 mg/kg/dose PO
Nitroprusside	0.5-10 mg/kg/min IV drip
Phentolamine	0.1-0.2 mg/kg IV (pheochromocytoma)

Atropine	0.01-0.02 mg/kg
Midazolam	0.1 - 0.3 mg/kg
Ketamine	1-2 mg/kg
Fentanyl	5 mcg/kg
Thiopental	2-4 mg/kg
Etomidate
Succinylcholine	1-2 mg/kg
Atracurium	0.5 mg/kg
Vecuronium	0.3 mg/kg
Pancuronium	0.1-0.2 mg/kg
Rocuronium

Ampicillin	200-400 mg/kg/day div q4-6h (max 2-4 g/d)
Cefotaxime	150 mg/kg/day div q8h
Ceftriaxone	100 mg/kg/day div q 24h (max 4g/d)
Decadron	0.15 mg/kg/dose IV q 6 hours x 4 days (prior to abx if possible)
Gentamicin	2.5 mg/kg/dose q 8 hours (pk 6-10, tr < 2)
Vancomycin	10-15 mg/kg/dose IV q 8-24h (pk 25-40, tr <10)

Chloral Hydrate	50-100 mg/kg PO/PR max 2 grams
Diazepam	0.05-0.2 mg/kg/dose IV
Ketamine	0.5-1 mg/kg IV or 3-7 mg/kg IM
Midazolam	0.05-0.2 mg/kg/dose IV
Thiopental	2-4 mg/kg IV

Diazepam	0.05-0.2 mg/kg/dose IM or IV
Midazolam	0.05-0.2 mg/kg/dose IM or IV
Phenytoin	15-20 mg/kg/dose IV (max 1g/24 hours)
Lorazepam	0.05-0,1 mg/kg/dose IV q15-20 minutes
Mannitol	0.25-1 g/kg IV q 5 minutes
Decadron	0.5-1.0 mg/kg IV