Tiny NETS logo Paediatric Clinical Calculator

Page 1 of 4
 For a child weighing ? kg, aged <1 year

The Paediatric Clinical Calculator is designed for patients weighing between 4 and 150 kg.

Note: Consider re-calculating using ideal body weight if the actual weight is significantly disproportionate to the age.

Between the Flags Observation Ranges

ObservationHR (/min)BPsys (mmHg)RR (/min)SpO2 (%)Temp (°C)
Age1 - 3 mo4 - 12 mo1 - 3 mo4 - 12 mo1 - 3 mo4 - 12 mo1 - 12 mo1 - 12 mo
Normal zone110 - 160100 - 16060 - 10070 - 11030 - 5530 - 4595 - 10035.5 - 38.5
Blue zone<110 or >160<100 or >160--<30 or >55<30 or >45 - -
Yellow zone<100 or >170<90 or >170<60 or >100<70 or >110<25 or >65<25 or >55<95<35.5 or >38.5
Red zone<80 or >190<80 or >180<50 or >120<60 or >130<20 or >75<15 or >65<90<34.5 or >41.0

Intubation Drugs

Key: NS=0.9% sodium chloride, WFI=Water For Injection & μg=micrograms
All drug doses are calculated for the IV route except where otherwise specified

Drug
vial content		 Dilution Dose Range Calculated Dose Based On
(Notes)		 Volume to
Draw up
atropine
600 μg/mL		 Add 1 mL to 5 mL WFI,
gives 100 μg/mL		 10 - 20 μg/kg
(0.1 - 0.2 mL/kg)		 ? 20 μg/kg
Maximium 600 μg		 ?
fentanyl
500 μg/10 mL		 Neat
(50 μg/mL)
Dilute small volumes with 1-2 mL NS		 2 - 5 μg/kg
(0.04 - 0.1 mL/kg)		 ? 2 μg/kg
Titrate to effect. Risk of chest rigidity if given rapidly		 ?
ketamine
200 mg/2 mL		 Add 2 mL to 8 mL WFI,
gives 20 mg/mL		 1 - 2 mg/kg
(0.05 - 0.1 mL/kg)		 ? 1.5 mg/kg
Caution in infants. Avoid <3mo.		 ?
propOFol 1%
200 mg/20 mL		 Neat
(10 mg/mL)		 ? ? ? ?
rocuronium
50 mg/5 mL		 Neat
(10 mg/mL)		 1.2 mg/kg
(0.12 mL/kg)		 ? Halve dose if needed for muscle-relaxation of ventilated patients ?
suxamethonium
100 mg/2 mL		 ? ? ? ? ?
thiopentone
500 mg		 Add 20 mL WFI,
gives 25 mg/mL		 2 - 5 mg/kg
(0.08 - 0.2 mL/kg)		 ? 2 mg/kg
Avoid if risk of hypotension		 ?

Endotracheal Tube

ETT Measurement Value
Cuffed ETT size 3.5 ± 0.5 mm
Uncuffed ETT size 4.0 ± 0.5 mm
Approximate
Oral ETT length		 8.0 cm
Approximate
Nasal ETT length		 9.0 cm
Supraglottic airways: LMA size ?, max cuff volume ? mL
Caution: LMA may be too large if weight < 1 - 2 kg,
i-gel® size N/A

Defibrillation/Cardioversion

Drug Initial Biphasic Dose Calculated Dose
VF/pulseless VT 4 J/kg 0 J
VT with pulse 2 J/kg
Double dose for repeat shocks		 0 J
SVT 1 J/kg
Double dose for repeat shocks		 0 J

Fluids

Fluid Requirement Volume/Rate
Stat bolus NS (or blood) [10 mL/kg] ?
100% Maintenance ?
2/3 Maintenance ?
50% Maintenance ?

Antimicrobials

Drug Initial Dose Calculated Dose
aciclovir
(over 60 min)		 ? ?
ampicillin
(over 30 min)		 50 mg/kg ?
azITHROMYCIN IV/PO
(over 60 min)		 10 mg/kg ?
benzylpenicillin
(Over 15 - 60 min)		 60 mg/kg ?
cefOTAXIME or cefTRIAXONE IV/IM*
(over 5-30 min)		 50 mg/kg ?
*IM preparation - reconsitute with WFI or 1% lignocaine, then calc dose vol from conc.
Cefotaxime: 1 g vial: Add 2.6 mL = 330 mg/mL, 2 g vial: Add 5 mL = 330 mg/mL
Ceftriaxone: 500 mg vial: Add 1.8 mL = 250 mg/mL, 1 g vial: Add 2.5 mL = 350 mg/mL
Ceftriaxone AFT: 500 mg vial: Add 1.7 mL = 250 mg/mL,
                            1 g vial: Add 2.3 mL = 350 mg/mL, 2 g vial: Add 4.6 mL = 350 mg/mL
clindamycin
(over 30 min)		 10 mg/kg ?
gentamicin
(over 5-30 min)		 7.5 mg/kg ?
metronidazole
(over 30 min)		 Loading: 15 mg/kg
Then: 7.5 mg/kg		 ?
piperacillin + tazobactam
(e.g. Tazocin EF®)
(over 30 min)		 100 mg/kg ?
vancomycin
(over ? min)		 15 mg/kg ?
Calculated   Printed copies are uncontrolled and may not be current NETS Clinical Calculator 5.8.7 - All rights reserved.
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Page 2 of 4
 For a child weighing ? kg, aged <1 year

Anticonvulsants

Drug
vial content		 Dilution Dose Range Calculated Dose Based On
(Notes)		 Volume to
Draw up
levetiracetam
(Keppra®)
500 mg/5 mL		 ? 40 - 60 mg/kg
(2.7 - 4.0 mL/kg)
over 5 - 15 min		 ? 40 mg/kg
Max: 4.5 g		 ?
midazolam IV
5 mg/mL		 Add 1 mL to 4 mL WFI,
gives 1 mg/mL		 0.15 mg/kg
(0.15 mL/kg)		 ? Max 10 mg ?
midazolam IN/buccal
5 mg/mL		 Neat
(5 mg/mL)		 0.3 - 0.5 mg/kg
(0.06 - 0.1 mL/kg)		 ? 0.3 mg/kg
Max 10 mg. Ideally use atomiser for IN		 ?
phenobarbital
(phenobarbitone)
200 mg/mL		 Neat
(200 mg/mL)		 20 mg/kg (0.1 mL/kg)
Give over 10 min & seek advice if repeat dose required		 ? Max 1000 mg. Dilute to a final concentration of at most 20 mg/mL with NS or 5% glucose ?
phenytoin
250 mg/5 mL		 Neat
(50 mg/mL)		 20 mg/kg
over 30 min		 ? Max 1500 mg. Dilute with NS to a conc of 3 - 10 mg/mL and start immediately. Use a 0.2-0.5 μm in-line filter ?

Miscellaneous Equipment

Gastric Tube Urinary Catheter Conventional
Intercostal Catheter		 Safe-T-Centesis
Pigtail Drain		 Optiflow™ Junior 2 Nasal Prongs
Options (for flows ≤2L/kg/min)
6-8F 5-6F 8-12F 6 or 8F Suggested initial flow rate = 0 L/min.
Junior 2: M (Yellow) or L (Purple) using MR850 or FP950+N40/P40
Calculated   Printed copies are uncontrolled and may not be current NETS Clinical Calculator 5.8.7 - All rights reserved.
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Page 3 of 4
 For a child weighing ? kg, aged <1 year

Bolus Drugs

Drug
vial content		 Dilution Dose Range Calculated Dose Based On
(Notes)		 Volume to
Draw up
adenosine
6 mg/2 mL		 Neat
(3 mg/mL)		 ? ? ? ?
adrenaline
(epinephrine) IV/IO
1:10,000		 Neat
(100 μg/mL)		 10 μg/kg
(0.1 mL/kg)		 ? Cardiac arrest dosing ?
adrenaline
(epinephrine) IM
1:1,000		 Neat
(1000 μg/mL)		 10 μg/kg
(0.01 mL/kg)		 ? Anaphylaxis dosing ?
adrenaline
(epinephrine) Neb
1:1,000		 Neat
(1000 μg/mL)		 0.5 mL/kg (max 5 mL) ? Upper airways obstruction dosing ?
amiNOPHYLLine
250 mg/10 mL		 ? 5 - 10 mg/kg
(5 - 10 mL/kg)		 ? 5 mg/kg
Give over 30 - 60 min		 ?
amiODAROne
(cardiac arrest)
150 mg/3 mL		 ? 5 mg/kg
(0.5 mL/kg)		 ? Give rapid bolus & flush with 5% glucose ?
amiODAROne
(arrhythmia load)
Peripheral line
150 mg/3 mL		 ? 6 mg/kg over 4 hrs
[≡ 25 μg/kg/min]		 ? Max dose 300 mg.
Use a PVC-free syringe/giving set & a 0.22 μm in-line filter		 ?
amiODAROne
(arrhythmia load)
Central line
150 mg/3 mL		 ? 6 mg/kg over 4 hrs
[≡ 25 μg/kg/min]		 ? Max dose 300 mg.
Use a PVC-free syringe/giving set & a 0.22 μm in-line filter		 ?
calcium chloride
10%		 Dilute 1:1 with WFI,
gives 0.34 mmol/mL		 0.14 mmol/kg
(0.4 mL/kg)		 ? Give slowly, use central
vein if possible		 ?
calcium gluconate
10%		 Neat
(0.22 mmol/mL)		 0.11 mmol/kg
(0.5 mL/kg)		 ? Give slowly, use central
vein if possible		 ?
fentanyl
100 μg/2 mL		 Add 2 mL to 8 mL NS,
gives 10 μg/mL		 1 - 2 μg/kg
(0.1 - 0.2 mL/kg)
analgesia		 ? 1 μg/kg
Risk of chest rigidity
if given rapidly		 ?
glucagon IV/IM
1 mg powder		 Add 1 mL WFI,
gives 1 mg/mL		 Not per kg ? Wait 30 mins before repeating ?
glucose
10%		 Neat
(0.1 g/mL)		 2 mL/kg ?   ?
hydrALAZINe
(Apresoline®)
20 mg powder		 Reconstitute in 1 mL WFI, then add to 49 mL NS, gives 0.4 mg/mL 0.15 to 0.6 mg/kg
(0.375 - 1.5 mL/kg)		 ? 0.15 mg/kg (Max 10 mg)
Give over 2 min, q4-6h.
Incompatible with glucose sols. Monitor BP closely		 ?
insulin (Actrapid®)
(hyperkalaemia)
100 units/1 mL		 ? ? ? ? ?
magnesium sulfate
50%		 Add 5 mL to 7.5 mL NS,
gives 0.8 mmol/mL		 0.2 mmol/kg
(0.25 mL/kg)		 ? For asthma, low Mg (over 30-60 mins) & arrhythmias (over 15-20 mins) ?
mannitol
20%		 Neat
(0.2 g/mL)		 0.25 - 1 g/kg
(1.25 - 5 mL/kg)		 ? 0.5 g/kg
Give over 20-60 min.
Use a ≤5 μm in-line filter		 ?
morphine sulfate or hydrochloride
10 mg/mL		 Add 1 mL to 9 mL WFI,
gives 1 mg/mL		 0.05 - 0.1 mg/kg
(0.05 - 0.1 mL/kg)		 ? 0.1 mg/kg
Titrate to effect		 ?
naloxone
400 μg/1 mL		 Neat
(400 μg/mL)		 10 μg/kg
(0.025 mL/kg)		 ? Max dose: 400 μg. Titrate to satifactory vital signs ?
saline (hypertonic)
3%		 Neat
(513 mmol/L)		 3 mL/kg ? Give over 10 - 20 min
Use central vein if possible		 ?
sodium bicarbonate
8.4%		 Dilute 1:1 with WFI,
gives 0.5 mmol/mL		 1 mmol/kg
(2 mL/kg)		 ? 1 mmol/kg
Give slow IV & use central vein if possible.
Halve for repeat doses		 ?
tranexamic acid
(loading dose)
500 mg/5 mL		 Neat
(100 mg/mL)		 15 mg/kg
(0.15 mL/kg)		 ? Use within 3hrs of trauma. Dilute in 10mL NS or 5% glucose. Give over 10 min ?
vecuronium
10 mg powder		 Dilute in 10 mL WFI,
gives 1 mg/mL		 0.1 mg/kg
(0.1 mL/kg)		 ?   ?
Calculated   Printed copies are uncontrolled and may not be current NETS Clinical Calculator 5.8.7 - All rights reserved.
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Page 4 of 4
 For a child weighing ? kg, aged <1 year

Continuous Infusions

Note: Vial Dose in Syringe volumes based upon the pre-dilution vial content listed in Drug column

Drug
vial content		 Dilution Vial Dose in Syringe Dose Range Infusion Rate
adrenaline
(epinephrine)
1 mg/mL		 0.15 mg/kg made up to 50 mL
with 5% or 10% glucose or NS		 ? 0.05 - 0.5 μg/kg/min 1 mL/hr =
0.05 μg/kg/min
In a cardiac arrest, if there are no 1:10,000 adrenaline bolus doses available, you can give a 3.3 mL bolus (10 μg/kg) of the infusion
amiODAROne
(maintenance)
Peripheral line
150 mg/3 mL		 ?
Use a PVC-free syringe/giving set & a 0.22 μm in-line filter		 ? 5 - 15 μg/kg/min ?
amiODAROne
(maintenance)
Central line
150 mg/3 mL		 ?
Use a PVC-free syringe/giving set & a 0.22 μm in-line filter		 ? 5 - 15 μg/kg/min ?
argipressin
(Pitressin®)
(refractory shock)
20 units/mL ≡
20,000 milliunits/mL		 10,000 milliunits (0.5 mL) made up to 50 mL
with 5% glucose or NS
(200 milliunits/mL)		 10 - 120 milliunits/kg/hr
Central line recommended
Monitor Na (initially 2nd hourly)		 ?
calcium chloride
(maintenance)
10%		 ? 0.5 - 1 mmol/kg/day
Use central line if possible.
Preferred in resuscitation		 ?
calcium gluconate
(maintenance)
10%		 ? 0.5 - 1 mmol/kg/day
Use central line if possible.
Less irritant than calcium chloride		 ?
clonidine
150 μg/1 mL		 ? ? 0.25 - 2 μg/kg/hr
May give 0.5 - 1 μg/kg initial dose over 10 minutes		 ?
dexmedetomidine
200 μg/2 mL		 ? ? 0.2 - 1.5 μg/kg/hr
Titrate by 0.1 - 0.2 μg/kg/hr steps as needed 30 minutely		 ?
dobutamine
250 mg/20 mL		 30 mg/kg made up to 50 mL with
5% glucose or NS		 ? 3 - 20 μg/kg/min ?
dopamine
200 mg/5 mL		 30 mg/kg made up to 50 mL with
5% glucose or NS		 ? 3 - 20 μg/kg/min ?
fentanyl
500 μg/10 mL		 50 μg/kg made up to 50 mL with
5% glucose or NS		 ? 0.5 - 4 μg/kg/hr - analgesia
0.5 - 10 μg/kg/hr - ventilated sedation		 ?
glyceryl trinitrite
50 mg/10 mL		 ? ? 0.5 - 5 μg/kg/min
Use central line only		 ?
heparin
(loading dose)
5000 units/5 mL		 Neat
(1,000 units/mL)		 100 units/kg
(0.1 mL/kg)		 ? over 30 min
May be diluted in up to 10 mL NS
heparin
(maintenance)
5000 units/5 mL		 ? ? 20 - 40 units/kg/hr
(max 1000 units/hr)		 ?
insulin (Actrapid®)
(DKA)
100 units/1 mL		 ? ? 0.05 - 0.1 units/kg/hr
Use a PVC-free syringe/giving set		 ?
ketamine
200 mg/2 mL		 ? ? 1 - 5 μg/kg/min - analgesia/sedation
10 - 20 μg/kg/min - anaesthesia		 ?
midazolam
5 mg/1 mL		 ? ? 1 - 6 μg/kg/min ?
milrinone
10 mg/10 mL		 ? ? 0.5 - 0.75 μg/kg/min ?
morphine sulfate
or hydrochloride
10 mg/1 mL		 ? ? 10 - 40 μg/kg/hr ?
noradrenaline
(norepinephrine)
2 mg/2 mL		 0.15 mg/kg made up to 50 mL
with 5% glucose		 ? 0.05 - 0.5 μg/kg/min 1 mL/hr =
0.05 μg/kg/min
propOFol 1%
200 mg/20 mL		 Neat
(10 mg/mL)		 1 - 4 mg/kg/hr ?
salbutamol
5 mg/5 mL		 Neat
(1 mg/mL)		 1 - 10 μg/kg/min
(Max rate 12 mL/hr)		 ?
sodium nitroprusside
50 mg/2 mL		 ? made up to 50 mL
with 5% glucose		 ? 0.5 - 5 μg/kg/min ?
tranexamic acid
(maintenance)
500 mg/mL		 ? ? ?
vasopressin See argipressin (Pitressin®) above
vecuronium
10 mg powder		 Reconstitute with 10 mL WFI
(1 mg/mL) 		50 - 200 μg/kg/hr ?
Calculated   Printed copies are uncontrolled and may not be current NETS Clinical Calculator 5.8.7 - All rights reserved.
Calculated   NETS Clinical Calculator 5.8.7 - All rights reserved.