Pediatric Dosages for Emergency, Airway, and Rapid Sequence Intubation Medications

1^st dose

2^nd dose

0.1 mg/kg

0.2 mg/kg

6 mg

12 mg

Rapid IV push followed immediately by 5-10 mL normal saline flush.

May repeat every 2 minutes.

Initial dose

High dose

Infusion

0.1 mL/kg, 1:10,000

0.1 mL/kg, 1:1,000

0.05-1 mcg/kg/min

1 mg

5 mL = 5 mg

–

May be given IV, IO. May repeat every 3-5 minutes PRN up to max dose.

May be given IV, IO, and ETT. May repeat every 3-5 min PRN.

Lower doses may be considered in neonates.

Neonate

Child

2-4 mL/kg of D10W

2-4 mL/kg of D25W

–

–

Then start continuous infusion of D10W at 6-8 mg/kg/min and titrat

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Stress dose

Acute adrenal

insufficiency

0.3-0.6 mg/kg

1-2 mg/kg

100 mg

Alternative dose: 25-100 mg/m² IV or 50 mg/m²/dose IM q12 hours.

May be given IV, IM.

Loading dose

Infusion

1 mg/kg

20-50 mcg/kg/min

–

2-4 mg/min

Antiarrhythmic dose. May be given IV, IO. ETT dose is 2-2.5 times higher.

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Etomidate

Fentanyl

Ketamine

Midazolam

Propofol

Thiopental

0.2 - 0.3 mg/kg

1 – 2 mcg/kg

1 - 2 mg/kg

0.1 – 0.2 mg/kg

2.5 – 3.5 mg/kg

3–7 mg/kg

20 mg

100 mcg

100 mg

10 mg

–

Decreases ICP. Minimal myocardial depression. May cause myoclonus.

May cause chest wall rigidity (reversible with naloxone or muscle relaxant).

Dissociative anesthetic. Consider for status asthmaticus. Sympathetic stimulant.

Titrate to effect. May cause hypotension. Reversible with flumazenil.

Reduces airway resistance and bronchospasm. Can cause hypotension.

Decreases ICP. In hypovolemia, use 1mg/kg. Can cause bronchospasm.

Pancuronium

Rocuronium

Succinylcholine

Vecuronium

0.1 mg/kg

0.6 – 1.2 mg/kg

1 – 2 mg/kg

0.1 – 0.2 mg/kg

–

70 mg

150 mg

10 mg

Avoid in cases of renal failure or tricyclic antidepressant use.

Minimal effect on heart rate or blood pressure.

Avoid in cases of hyperkalemia, severe burn or myopathy with increased CPK.

Minimal effect on heart rate or blood pressure.

Albuterol*

Ipratropium bromide

Racemic epinephrine

0.25 – 1 mL

0.025 mg – 0.5 mg

0.25 – 0.5 mL

1 mL

0.5 mg

0.5 mL

0.5% solution (5 mg/mL). May give as continuous neb up to 4 mL/hr.

May help prevent need for hospitalization if given in the ED.

2.25% solution.

Epinephrine

Terbutaline

0.01 mL/kg

0.005 – 0.01 mg/kg

0.5 mL

0.4 mg

1:1000 solution. May repeat q15 minutes x 3 doses.

Usual adult dose = 0.25 mg.

Dexamethasone

Magnesium sulfate

Methylprednisolone

Terbutaline: Bolus

                  Infusion

0.6 mg/kg

50 mg/kg

2 mg/kg

2 – 10 mcg/kg

0.08 – 0.4 mcg/kg/min

8 mg

2 grams

–

–

3 mcg/kg/min

May be given IV, IM, and/or PO. Often used for airway edema/croup.

May cause hypotension, apnea, or complete heart block. Infuse over 20 minutes

After loading dose, give 1 mg/kg q12 hours.

Initial bolus usually followed by continuous infusion.

Titrate to effect in increments of 0.1 mcg/kg/min q30 minutes.