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EMERGENCY MEDICATIONS AND THERAPY FOR NEONATESa
MEDICATIONINDICATIONSDOSING RANGEINITIAL KG DOSINGNOTESUMBILICAL CATHETER DOSINGb
UACUVC
Atropine (0.05 mg/mL)Bradycardia 0.01–0.03 mg/kg/dose IV, IM, ET; repeat every 10 to 15 minutes (0.4–0.6 mL/kg/dose)

1 kg : 0.4 mL

2 kg : 0.8 mL

3 kg : 1.2 mL

4 kg : 1.6 mL

Prefilled syringe 0.05 mg/ml

For ET use, must be diluted with NS

Yes
Calcium gluconate (10%) (100 mg/mL)

Hyperkalemia

Hypocalcemia

Ca gluconate 100–200 mg/kg slow IV over 10–30 minutes (1.0–2.0 mL/kg)

1 kg : 1 mL

2 kg : 2 mL

3 kg : 3 mL

4 kg : 4 mL

Infuse slowly; caution with digitalized patient; tissue necrosis if extravasation. Can also use Ca chloride 20-30 mg/kg

Yes
Dextrose

Hypoglycemia

Hyperkalemia (used with insulin)

100–500 mg/kg/dose IV (1–5 mL/kg/dose D10W)

1 kg : 2.5 mL D10

2 kg : 5.0 mL D10

3 kg : 7.5 mL D10

4 kg : 10 mL D10

D10 = 100 mg/ml; D12.5 = 125 mg/ml; D25 = 250 mg/ml (D25 only in central line)YesYes
DobutamineCardiogenic shock, hypotension due to refractory CHF2–15 mcg/kg/minute, increase every 10 minutes to maximum 40 mcg/kg/minute

1 kg : 5 mcg/minute

2 kg : 10 mcg/minute

3 kg : 15 mcg/minute

4 kg : 20 mcg/minute

1 vial = 250 mg/20 ml; 250 mg in 500 mL = 500 mcg/ml (mix in D5W, NS, LR)Yes
DopamineHypotension, agonal heart5 mcg/kg/minute, increase to a maximum of 40 mcg/kg/minute

1 kg : 5 mcg/minute

2 kg : 10 mcg/minute

3 kg : 15 mcg/minute

4 kg : 20 mcg/minute

1 vial = 200 mg

200 mg in 250 mL = 800 mcg/mL mix in D5W, NS, LR

Yes
Cardioversion/DefibrillationVT, VF, SVT, atrial fib/flutter1–4 joules/kg, increase 50-100% each time***Synch switch off for VF***
Epinephrine (1:10,000)Asystole, bradycardia, hypotension (acute)0.1–0.3 mL/kg/dose of 1:10,000 IV; ET consider 0.3–1 mL/kg/dose of 1:10,000 (dilute with NS)

1 kg : 0.2 mL

2 kg : 0.4 mL

3 kg : 0.6 mL

4 kg : 0.8 mL

Do not use 1:1000; for ET use, dilute in 1–2 ml NS; AHA, AAP suggests higher ET dose, but safety unknownYes
Endotracheal Tube

2.5 mm Internal diameter, uncuffed

3.0 mm Internal diameter, uncuffed

3.5 mm Internal diameter, uncuffed

4.0 mm Internal diameter, uncuffed

<1000 gm or <28 weeks

1000–2000 gm 28–34 weeks

2000–3000 gm 34–36 weeks

>3000 gm >38 weeks

Furosemide (10 mg/mL)Volume overload, pulmonary edema1 mg/kg/dose, IM, IV (0.1 mL/kg/dose)

1 kg : 0.1 mL

2 kg : 0.2 mL

3 kg : 0.3 mL

4 kg : 0.4 mL

Yes
Insulin (1 unit/mL)Hyperkalemia0.1–0.2 units/kg/dose (0.1–0.2 mL/kg/dose of 1 unit/mL) (with dextrose 600–800 mg/kg/dose) (D10 = 100 mg/mL)

1 kg : 0.2 mL

2 kg : 0.4 mL

3 kg : 0.6 mL

4 kg : 0.8 mL

Use regular insulin diluted to 1 unit/mL; glucose to insulin ratio of 3-4:1; follow ...

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