Paediatric Clinical Calculator

	Paediatric Clinical Calculator	Page 1 of 4
	For a child weighing 16 kg, aged 3 years

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

Observation	HR (/min)	BP_sys (mmHg)	RR (/min)	SpO₂ (%)	Temp (°C)
Normal zone	90 - 140	90 - 110	20 - 40	95 - 100	35.5 - 38.5
Blue zone	<90 or >140	<90 or >110	>40	-	-
Yellow zone	<80 or >150	<80 or >120	<20 or >50	<95	<35.5 or >38.5
Red zone	<70 or >170	<70 or >150	<15 or >60	<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)	320 μg	20 μg/kg Maximium 600 μg	3.2 mL
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)	32 μg	2 μg/kg Titrate to effect. Risk of chest rigidity if given rapidly	0.64 mL
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)	24 mg	1.5 mg/kg Caution in infants. Avoid <3mo.	1.2 mL
propOFol 1% 200 mg/20 mL	Neat (10 mg/mL)	2.5 - 3.5 mg/kg (0.25 - 0.35 mL/kg)	40 mg	2.5 mg/kg Caution if risk of hypotension	4.0 mL
rocuronium 50 mg/5 mL	Neat (10 mg/mL)	1.2 mg/kg (0.12 mL/kg)	19 mg	Halve dose if needed for muscle-relaxation of ventilated patients	1.9 mL
suxamethonium 100 mg/2 mL	Add 1 mL to 9 mL WFI, gives 5 mg/mL	1 - 2 mg/kg (0.2 - 0.4 mL/kg)	32 mg	2 mg/kg Avoid if high K+, neuromuscular disease or malignant hyperthermia	6.4 mL
thiopentone 500 mg	Add 20 mL WFI, gives 25 mg/mL	2 - 5 mg/kg (0.08 - 0.2 mL/kg)	32 mg	2 mg/kg Avoid if risk of hypotension	1.3 mL

Endotracheal Tube

ETT Measurement	Value
Cuffed ETT size	4.0 ± 0.5 mm
Uncuffed ETT size	4.5 ± 0.5 mm
Approximate Oral ETT length	14.5 cm
Approximate Nasal ETT length	16.5 cm
Supraglottic airways: LMA size 2, max cuff volume 10 mL, i-gel^® size 2, max OGT size 12F

Defibrillation/Cardioversion

Drug	Initial Biphasic Dose	Calculated Dose
VF/pulseless VT	4 J/kg	64 J
VT with pulse	2 J/kg Double dose for repeat shocks	32 J
SVT	1 J/kg Double dose for repeat shocks	16 J

Fluids

Fluid Requirement	Volume/Rate
Stat bolus NS (or blood) [10 mL/kg]	160 mL
100% Maintenance	54 mL/hr
2/3 Maintenance	36 mL/hr
50% Maintenance	27 mL/hr

Antimicrobials

Drug	Initial Dose	Calculated Dose
aciclovir (over 60 min)	20 mg/kg	320 mg
ampicillin (over 30 min)	50 mg/kg	800 mg
azITHROMYCIN IV/PO (over 60 min)	10 mg/kg	160 mg
benzylpenicillin (Over 15 - 60 min)	60 mg/kg	960 mg
cefOTAXIME or cefTRIAXONE IV/IM^* (over 5-30 min)	50 mg/kg	800 mg
^*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	160 mg
gentamicin (over 5-30 min)	7.5 mg/kg	120 mg
metronidazole (over 30 min)	Loading: 15 mg/kg Then: 7.5 mg/kg	Loading: 240 mg Then: 120 mg
piperacillin + tazobactam (e.g. Tazocin EF^®) (over 30 min)	100 mg/kg	1.6 g
vancomycin (over 60 min)	15 mg/kg	240 mg

Calculated

Printed copies are uncontrolled and may not be current

	Paediatric Clinical Calculator	Page 2 of 4
	For a child weighing 16 kg, aged 3 years

Anticonvulsants

Drug vial content	Dilution	Dose Range	Calculated Dose	Based On (Notes)	Volume to Draw up
levetiracetam (Keppra^®) 500 mg/5 mL	Add 6.4 mL to 36 mL NS giving 15 mg/mL	40 - 60 mg/kg (2.7 - 4.0 mL/kg) over 5 - 15 min	640 mg	40 mg/kg Max: 4.5 g	42.4 mL
midazolam IV 5 mg/mL	Add 1 mL to 4 mL WFI, gives 1 mg/mL	0.15 mg/kg (0.15 mL/kg)	2.4 mg	Max 10 mg	2.4 mL
midazolam IN/buccal 5 mg/mL	Neat (5 mg/mL)	0.3 - 0.5 mg/kg (0.06 - 0.1 mL/kg)	4.8 mg	0.3 mg/kg Max 10 mg. Ideally use atomiser for IN	0.96 mL
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	320 mg	Max 1000 mg. Dilute to a final concentration of at most 20 mg/mL with NS or 5% glucose	1.6 mL
phenytoin 250 mg/5 mL	Neat (50 mg/mL)	20 mg/kg over 30 min	320 mg	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	6.4 mL

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)
10F	8F	16-24F	6 or 8F	Suggested initial flow rate = 35 L/min. Junior 2: XL (Green) using FP950+P40 Junior 2: XXL (Grey) using MR850, FP950+N40/P40 or Airvo™ 2/3

Calculated

Printed copies are uncontrolled and may not be current

	Paediatric Clinical Calculator	Page 3 of 4
	For a child weighing 16 kg, aged 3 years

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)	0.1 - 0.5 mg/kg in 0.1 mg/kg increments	1.6 mg	0.1 mg/kg Give proximally + rapid flush	0.53 mL
adrenaline (epinephrine) IV/IO 1:10,000	Neat (100 μg/mL)	10 μg/kg (0.1 mL/kg)	160 μg	Cardiac arrest dosing	1.6 mL
adrenaline (epinephrine) IM 1:1,000	Neat (1000 μg/mL)	10 μg/kg (0.01 mL/kg)	160 μg	Anaphylaxis dosing	0.16 mL
adrenaline (epinephrine) Neb 1:1,000	Neat (1000 μg/mL)	0.5 mL/kg (max 5 mL)	5.0 mL	Upper airways obstruction dosing	5.0 mL
amiNOPHYLLine 250 mg/10 mL	Add 3.2 mL to 76.8 mL 5% glucose or NS, gives 1 mg/mL	5 - 10 mg/kg (5 - 10 mL/kg)	80 mg	5 mg/kg Give over 30 - 60 min	80 mL
amiODAROne (cardiac arrest) 150 mg/3 mL	Add 3 mL to 12 mL 5% glucose, gives 10 mg/mL	5 mg/kg (0.5 mL/kg)	80 mg	Give rapid bolus & flush with 5% glucose	8.0 mL
amiODAROne (arrhythmia load) Peripheral line 150 mg/3 mL	Add 2 mL to 48 mL 5% glucose, gives 2 mg/mL	6 mg/kg over 4 hrs [≡ 25 μg/kg/min]	96 mg	Max dose 300 mg. Use a PVC-free syringe/giving set & a 0.22 μm in-line filter	Run at: 12 mL/hr Total in 4 hrs: 48 mL
amiODAROne (arrhythmia load) Central line 150 mg/3 mL	Add 4.8 mL to 45 mL 5% glucose, gives 4.8 mg/mL	6 mg/kg over 4 hrs [≡ 25 μg/kg/min]	96 mg	Max dose 300 mg. Use a PVC-free syringe/giving set & a 0.22 μm in-line filter	Run at: 5.0526315789474 mL/hr Total in 4 hrs: 20.4 mL
calcium chloride 10%	Dilute 1:1 with WFI, gives 0.34 mmol/mL	0.14 mmol/kg (0.4 mL/kg)	2.2 mmol	Give slowly, use central vein if possible	6.4 mL
calcium gluconate 10%	Neat (0.22 mmol/mL)	0.11 mmol/kg (0.5 mL/kg)	1.8 mmol	Give slowly, use central vein if possible	8.0 mL
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	16 μg	1 μg/kg Risk of chest rigidity if given rapidly	1.6 mL
glucagon IV/IM 1 mg powder	Add 1 mL WFI, gives 1 mg/mL	Not per kg	0.5 mg	Wait 30 mins before repeating	0.5 mL
glucose 10%	Neat (0.1 g/mL)	2 mL/kg	32 mL		32 mL
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)	2.4 mg	0.15 mg/kg (Max 10 mg) Give over 2 min, q4-6h. Incompatible with glucose sols. Monitor BP closely	6.0 mL
insulin (Actrapid^®) (hyperkalaemia) 100 units/1 mL	Add 50 units (0.5 mL) to 49.5 mL 10% glucose or NS, gives 1.0 unit/mL	0.1 units/kg (0.1 mL/kg)	1.6 units (1.6 mL)	Give insulin dose with 80mL 10% glucose over 15-30 min. Check BSL q30 min for 2 hr	1.6 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)	3.2 mmol	For asthma, low Mg (over 30-60 mins) & arrhythmias (over 15-20 mins)	4.0 mL
mannitol 20%	Neat (0.2 g/mL)	0.25 - 1 g/kg (1.25 - 5 mL/kg)	8.0 g	0.5 g/kg Give over 20-60 min. Use a ≤5 μm in-line filter	40 mL
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)	1.6 mg	0.1 mg/kg Titrate to effect	1.6 mL
naloxone 400 μg/1 mL	Neat (400 μg/mL)	10 μg/kg (0.025 mL/kg)	160 μg	Max dose: 400 μg. Titrate to satifactory vital signs	0.40 mL
saline (hypertonic) 3%	Neat (513 mmol/L)	3 mL/kg	48 mL	Give over 10 - 20 min Use central vein if possible	48 mL
sodium bicarbonate 8.4%	Dilute 1:1 with WFI, gives 0.5 mmol/mL	1 mmol/kg (2 mL/kg)	16 mmol	1 mmol/kg Give slow IV & use central vein if possible. Halve for repeat doses	32 mL
tranexamic acid (loading dose) 500 mg/5 mL	Neat (100 mg/mL)	15 mg/kg (0.15 mL/kg)	240 mg	Use within 3hrs of trauma. Dilute in 10mL NS or 5% glucose. Give over 10 min	2.4 mL
vecuronium 10 mg powder	Dilute in 10 mL WFI, gives 1 mg/mL	0.1 mg/kg (0.1 mL/kg)	1.6 mg		1.6 mL

Calculated

Printed copies are uncontrolled and may not be current

	Paediatric Clinical Calculator	Page 4 of 4
	For a child weighing 16 kg, aged 3 years

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	2.4 mg (2.4 mL)	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	2 mL to 48 mL 5% glucose Use a PVC-free syringe/giving set & a 0.22 μm in-line filter	100 mg (2.0 mL)	5 - 15 μg/kg/min	4.8 mL/hr = 10 μg/kg/min
amiODAROne (maintenance) Central line 150 mg/3 mL	15 mg/kg made up to 50 mL with 5% glucose Use a PVC-free syringe/giving set & a 0.22 μm in-line filter	240 mg (4.8 mL)	5 - 15 μg/kg/min	2 mL/hr = 10 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 2^nd hourly)	0.80 mL/hr = 10 milliunits/kg/hr
calcium chloride (maintenance) 10%	10 mL made up to 50 mL with 5% glucose or NS (0.136 mmol/mL)		0.5 - 1 mmol/kg/day Use central line if possible. Preferred in resuscitation	2.5 mL/hr = 0.5 mmol/kg/day
calcium gluconate (maintenance) 10%	10 mL made up to 20 mL with 5% glucose or NS (0.11 mmol/mL)		0.5 - 1 mmol/kg/day Use central line if possible. Less irritant than calcium chloride	3.0 mL/hr = 0.5 mmol/kg/day
clonidine 150 μg/1 mL	50 μg/kg made up to 50 mL with 5% glucose or NS	800 μg (5.3 mL)	0.25 - 2 μg/kg/hr May give 0.5 - 1 μg/kg initial dose over 10 minutes	1 mL/hr = 1 μg/kg/hr
dexmedetomidine 200 μg/2 mL	2 mL added to 48 mL of 5% glucose or NS	200 μg (2.0 mL)	0.2 - 1.5 μg/kg/hr Titrate by 0.1 - 0.2 μg/kg/hr steps as needed 30 minutely	2.0 mL/hr = 0.5 μg/kg/hr
dobutamine 250 mg/20 mL	30 mg/kg made up to 50 mL with 5% glucose or NS	480 mg (38 mL)	3 - 20 μg/kg/min	1 mL/hr = 10 μg/kg/min
dopamine 200 mg/5 mL	30 mg/kg made up to 50 mL with 5% glucose or NS	480 mg (12 mL)	3 - 20 μg/kg/min	1 mL/hr = 10 μg/kg/min
fentanyl 500 μg/10 mL	50 μg/kg made up to 50 mL with 5% glucose or NS	800 μg (16 mL)	0.5 - 4 μg/kg/hr - analgesia 0.5 - 10 μg/kg/hr - ventilated sedation	1 ml/hr = 1 μg/kg/hr
glyceryl trinitrite 50 mg/10 mL	3 mg/kg made up to 50 mL with 5% glucose or NS	48 mg (9.6 mL)	0.5 - 5 μg/kg/min Use central line only	1.0 mL/hr = 1 μg/kg/min
heparin (loading dose) 5000 units/5 mL	Neat (1,000 units/mL)		100 units/kg (0.1 mL/kg)	1.6 mL over 30 min May be diluted in up to 10 mL NS
heparin (maintenance) 5000 units/5 mL	500 units/kg (0.5 mL/kg) made up to 500 mL with 5% glucose or NS	8,000 units (8.0 mL)	20 - 40 units/kg/hr (max 1000 units/hr)	25 mL/hr = 25 units/kg/hr
insulin (Actrapid^®) (DKA) 100 units/1 mL	50 units (0.5 mL) made up to 50 mL with NS	50 units (0.50 mL)	0.05 - 0.1 units/kg/hr Use a PVC-free syringe/giving set	1.6 mL/hr = 0.1 units/kg/hr
ketamine 200 mg/2 mL	6 mg/kg made up to 50 mL with 5% glucose or NS	96 mg (0.96 mL)	1 - 5 μg/kg/min - analgesia/sedation 10 - 20 μg/kg/min - anaesthesia	1 mL/hr = 2 μg/kg/min
midazolam 5 mg/1 mL	3 mg/kg made up to 50 mL with 5% glucose or NS	48 mg (9.6 mL)	1 - 6 μg/kg/min	2 mL/hr = 2 μg/kg/min
milrinone 10 mg/10 mL	1.5 mg/kg made up to 50 mL with 5% glucose or NS	24 mg (24 mL)	0.5 - 0.75 μg/kg/min	1.0 mL/hr = 0.5 μg/kg/min
morphine sulfate or hydrochloride 10 mg/1 mL	1 mg/kg made up to 50 mL with 5% glucose or NS	16 mg (1.6 mL)	10 - 40 μg/kg/hr	1 mL/hr = 20 μg/kg/hr
noradrenaline (norepinephrine) 2 mg/2 mL	0.15 mg/kg made up to 50 mL with 5% glucose	2.4 mg (2.4 mL)	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	3.2 mL/hr = 2 mg/kg/hr
salbutamol 5 mg/5 mL	Neat (1 mg/mL)		1 - 10 μg/kg/min (Max rate 12 mL/hr)	0.96 mL/hr = 1 μg/kg/min
sodium nitroprusside 50 mg/2 mL	3 mg/kg made up to 50 mL with 5% glucose	48 mg (1.9 mL)	0.5 - 5 μg/kg/min	1 mL/hr = 0.5 μg/kg/min
tranexamic acid (maintenance) 500 mg/mL	Add 500 mg (1 mL) in 500 mL NS		2 mg/kg/hr	32 mL/hr = 2 mg/kg/hr
vasopressin	See argipressin (Pitressin^®) above
vecuronium 10 mg powder	Reconstitute with 10 mL WFI (1 mg/mL)		50 - 200 μg/kg/hr	1.6 mL/hr = 100 μg/kg/hr

Calculated

Printed copies are uncontrolled and may not be current