Pediatric Airway Equipment

Endotracheal Tube (ETT)
Uncuffed ETT size: (age/4) +4; Cuffed ETT size: (age/4) +3.5, ETT depth <1 yr: Wt/2 + 8, > 1 yr: age/2 + 12
The neonatal “1-2-3/6-7-8” Rule (1kg: tape at 6 cm, etc.)
*ALWAYS have available airway equipment one size above and below calculated.
Pediatric Drugs
Emergency Drugs
- Epinephrine
- 10 mcg/kg IV; infusion: 0.02-0.5 mcg/kg/min
- Anaphylaxis: IM: 10 mcg/kg every 5-15 min; IV: 1 mcg/kg, titrate for response
- Atropine
- 20 mcg/kg IV (min 0.1 mg)
- Succ + atropine dart (80 mg/0.4 mg)
- IM: 4 mg/kg (of succinylcholine); IV: 1 mg/kg
- (1 cc = sux 16 mg + atropine 80 mcg)
- Adenosine
- Initial bolus: 0.1 mg/kg IV Repeat dose: 0.2 mg/kg IV (max 12 mg)
- Amiodarone
- 5 mg/kg IV
- Calcium Chloride
- 5-20 mg/kg IV (usual dose 10 mg/kg) For central line administration
- Calcium Gluconate
- 15-100 mg/kg IV (usual dose 30 mg/kg) Can be given via PIV
- Dantrolene
- 2.5 mg/kg IV (max 10 mg/kg)
- Dexamethasone
- 0.1-0.5 mg/kg IV
- Dextrose (D25W/D50W)
- 0.5-1 gr/kg IV
- Diphenhydramine
- 0.5-1 mg/kg IV, IM, or PO
- Dopamine
- 2-20 mcg/kg/min IV infusion
- Ephedrine
- 0.1-0.3 mg/kg IV
- Racemic epi 2.25%
- 0.05 mL/kg in NaCl 0.9% 3 cc (nebulized)
- Flumazenil
- 10 mcg/kg IV
- Naloxone
- 10 mcg/kg IV (give divided doses)
- Phenylephrine
- 1-10 mcg/kg IV
- For TOF hypercyanotic spells, NOT for routine tx of hypotension in children
- Sodium Bicarbonate
- 1 mEq/kg IV
- Magnesium Sulfate
- 25-50 mg/kg IV (max 2 gr)
Premedication
- Midazolam
- PO: 0.5 mg/kg (max 20 mg); IV: 0.05-0.1 mg/kg (max 2 mg)
- Ketamine
- PO: 6-10 mg/kg; IV 0.5-1 mg/kg; IM: 3 mg/kg
- Dexmedetomidine
- Intranasal: 1 mcg/kg (undiluted, 100 mcg/cc solution)
Induction Agents
- Propofol
- 2-3 mg/kg IV Maintenance: ~250 mcg/kg/min
- Ketamine
- 1-3 mg/kg IV
- Etomidate
- 0.3 mg/kg IV
- Thiopental
- 5-6 mg/kg IV (currently not available in the US)
- Methohexital
- 1 mg/kg IV
Muscle Relaxants
- Rocuronium
- 0.6-1.2 mg/kg IV
- Vecuronium
- 0.1 mg/kg
- Succinylcholine
- 1-3 mg/kg (neonates require doses at the higher end)
- Cisatracurium
- 0.15 mg/kg
Opioids
- Fentanyl
- IV: 1-5 mcg/kg
- Intranasal: 2 mcg/kg
- If used as main anesthetic (e.g., CDH repair in NICU): 25-50 mcg/kg
- Morphine
- 0.05-0.1 mg/kg IV
- Remifentanil
- Bolus: 0.25-1 mcg/kg IV
- Infusion: 0.05-0.2 mcg/kg/min IV
- Sufentanil
- 0.5-1 mcg/kg IV
- Infusion: 0.05-0.2 mcg/kg/hr IV
- Hydromorphone
- 0.005-0.01 mg/kg IV
- Oxycodone
- 0.1 mg/kg PO
Analgesics
- Acetaminophen
- Neonates: 20-30 mg/kg PR
- Children 3-25 kg: 30-40 mg/kg PR; 10-20 mg/kg PO
- Children >25 kg: 15 mg/kg IV. Maximum per day: 60 mg/kg
- Ketorolac
- 0.5 mg/kg IV (max 30 mg)
- Ibuprofen
- 10 mg/kg
Antiemetics
- Ondansetron
- 0.1-0.15 mg/kg IV (up to 4 mg)
- Dexamethasone
- 0.5 mg/kg IV (up to 8 mg)
- Metoclopramide
- 0.1 mg/kg IV (up to 10 mg)
Common Antibiotics
- Ampicillin
- 50 mg/kg IV
- Ampi/sulbactam (unasyn)
- 25-50 mg/kg IV
- Cefazolin
- 25-30 mg/kg IV
- Cefotaxime
- 25-50 mg/kg IV
- Ciprofloxacin
- 7.5-10 mg/kg IV
- Ceftriaxone
- 25-50 mg/kg IV
- Clindamycin
- 15 mg/kg IV
- Gentamicin
- 2 mg/kg IV
- Metronidazole
- 7.5 mg/kg IV
- Zosyn
- 50-100 mg/kg IV (usual dose: 75 mg/kg)
- Vancomycin
- 15 mg/kg IV
Source: Dr. Shaik and Dr. Gonzalez