Important
This tool is designed to be a readily available guide to endotracheal tube sizes and positions, and to doses of drugs and other therapies.
It is not a recipe book -it is important that you think carefully if "standard" doses of drugs are appropriate for any individual patient, especially acutely unstable ones.
For minimum systolic blood pressure, and heart and respiratory rate - look at trends as well as absolute numbers.
Do not just blindly follow the doses given here - think first.
Information presented here comes from several sources, particularly Drug Doses by Frank Shann. The algorithm comes from the Australian Resuscitation Council
http://www.resus.org.au
Doses have been rounded where sensible to do so, and minimum and maximum doses applied to some drugs.
Doses may need to be modified if drugs are used in combination.
DC shock energy has been rounded to figures commonly found on defibrillators. 4j/kg
DC shock energy has been rounded to figures commonly found on defibrillators. 4j/kg
For Morphine, Fentanyl, Thiopentone and Propofol it is important to titrate the dose for its desired effect. Be very cautious of hypotension in sick children and respiratory depression if not ventilated. Be careful in patients with haemodynamic compromise - cardiac failure, pulmonary hypertension, septic shock. Correct hypovolaemia first. Have vasopressors available (eg metaraminol 5-10 mcg/kg). Be careful of propofol in infants
<1 year of age dosing is more complex.
Propofol is based on approximately: 1-5yo: 2.5-3.5 mg/kg, 5-10yo: 2-3 mg/kg, >10: 1.5-2.5 mg/kg
Suxamethonium is based on 3 mg/kg for newborn, 2 mg/kg child, 1 mg/kg adult.
I've done my best to ensure this information is accurate and cross checked doses with other experts but it is your responsibility to verify doses etc before using this tool.
Comments and suggestions welcome
Mike.South@rch.org.au
Mike
Prof Mike South
Director
Department of General Medicine, Specialist in Intensive Care
Professor, University of Melbourne
Royal Children's Hospital, Parkville, Victoria 3052, Australia