20kg (6yr)

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Critical Care Quick Reference Group

Weight 20 kg
Age 6 years
Broselow Color Blue

Normal Vital Signs

Heart Rate 70-110 bpm
Respiratory Rate 18-24 rpm
Systolic BP 80-110 mmHg



Intubation

Medication Dose Calculation
Pretreatment
Lidocaine 30 mg 1.5 mg/kg[1]
Fentanyl 20 mcg 1 mcg/kg
RSI
Etomidate 6 mg 0.3 mg/kg
Succinylcholine 30 mg 1.5 mg/kg
Midazolam (Versed) 2 mg 0.1 mg/kg
(max 2 mg per dose)
Ketamine 40 mg 2 mg/kg
Vecuronium 2 mg 0.1 mg/kg
Rocuronium 20 mg 1 mg/kg
Equipment
ET Tube (cuffed) 5 ±0.5 age/4+3
ET Tube (uncuffed)6 ±0.5age/4+4
Blade 3-4 Miller or MAC
cm to teeth 15 3 x ETT size

Pulseless Arrest

Medication Dose Calculation
Defibrilation 40 J 2 J/kg
(max 200)
Epinephrine (1:10,000) 0.2 mg 0.01 mg/kg
(max 1 mg)
Amiodarone load (without pulse) 100 mg 5 mg/kg
(max 300)
Lidocaine 20 mg 1 mg/kg
Lidocaine Infusion 1000 mcg/min 50 mcg/kg/min
Magnesium sulfate 1000 mg 50 mg/kg
(max 2000 mg)
CalCl (100mg/mL) 400 20 mg/kg
(max 1000 mg)
Sodium Bicarbonate (8.4%) 20mL 1 mL/kg
(max 50 mL)

Cardiac with Pulse

Medication Dose Calculation
Adenosine 2 mg 0.1 mg/kg
(max 6 mg)
Adenosine Repeat 4 mg 0.2 mg/kg
(max 12 mg)
Amiodarone load (with pulse) 100 mg 5 mg/kg
Amiodarone 2nd/3rd dose repeat loading dose up to total 3 times 15 mg/kg max
Atropine 0.4 mg 0.02 mg/kg
(max 1 mg)
Cardioversion First Shock 20 J 1 J/kg
Cardioversion Second Shock 40 J 2 J/kg
Procainamide 300 mg 15 mg/kg
(max 1500 mg)
Diltiazem 5 mg 0.25 mg/kg
Esmolol 2000 mcg/min 100 mcg/kg/min
Magnesium sulfate 1000 mg 50 mg/kg
Nitroglycerin drip 1 mcg 0.05 mcg/kg/min
Glucagon 0.5 mg 0.025 mg/kg

Hypoglycemia

Medication Dose Calculation
D25W 40 mL 2 mL/kg
D10 W 50 mL 2.5 mL/kg
Glucagon 0.5 mg 0.025 mg/kg

Vasopressors

Medication IV Dose (mcg/kg/min) Concentration
Norepinephrine (Levophed) 0.1-2 mcg/kg/min 8mg in 500mL D5W
Dopamine 2-20 mcg/kg/min 400mg in 250 D5W
Dobutamine 2-20 mcg/kg/min 250mg in 250 mg D5W
Epinephrine 0.1-1 mcg/kg/min 1mg in 250 D5W

Sedation

Medication Dose Calculation
Lorazepam (Ativan) 1 mg 0.05 mg/kg
(max 2 mg per dose)
Morphine 2 mg 0.1 mg/kg
Fenatnyl 20 mcg 1 mcg/kg
Ketamine 20 mg 1 mg/kg
Midazolam (Versed) 2 mg 0.1 mg/kg
(max 2 mg per dose)
Propofol IV (initial) 20 mg 1 mg/kg
Propofol (drip) 1000 mcg 50 mcg/kg/min

Seizure and CNS

Medication Dose Calculation
Lorazepam (Ativan) 1 mg 0.05 mg/kg
(max 2 mg per dose)
Fosphenytoin (PE = phenytoin equivalent) 400 PE 20 PE/kg
Phenytoin (Dilantin) 400 mg 20 mg/kg
Phenobarbitol 200 mg 10 mg/kg
Diazepam (Valium) rectal 2 mg 0.1 mg/kg every 2 min
Levetiracetam (Keppra) 400 mg 20 mg/kg
Mannitol 20 g 1 g/kg
Hypoglycemia IV dextrose see glucose table

Trauma

Medication Dose Calculation
Normal saline 0.9% bolus 400mL
PRBCs (1u=250mL) 200mL
Chest tube (fr) 28
Central line 4F (IJ/subclavian)

4-5F (femoral)

NG tube (fr) 12

Equipment

Medication Dose Calculation
Chest tube (fr) 28
Central line 4F (IJ/subclavian)

4-5F (femoral)

NG tube (fr) 12

Fluids

Medication Dose Calculation
Normal saline 0.9% bolus 400mL 20 mL/kg
Maintenance 60mL/hr 4-2-1 Rule
PRBCs (1u=250mL) 200mL

See Also

Quick Reference Groups[2]

Adult
Category Weight
Large adult 100kg
ADULT 70kg
Small adult 50kg
Pediatric
Broslow Color Weight (Age)
Green 35kg (10yr)
Orange 25kg (8yr)
Blue 20kg (6yr)
White 15kg (4yr)
Yellow 12kg (2yr)
Purple 10kg (1yr)
Red 8kg (6mo)
Pink 6kg (4mo)
Gray 5kg (2mo)
3.5kg (newborn)
Premie 2kg (preemie)

References

  1. ↑ Robinson N, Clancy M. Emerg Med J. 2001 Nov; 18(6): 453–457. In patients with head injury undergoing rapid sequence intubation, does pretreatment with intravenous lignocaine/lidocaine lead to an improved neurological outcome? A review of the literature doi:10.1136/emj.18.6.453 PMCID:PMC1725712
  2. ↑ Unless otherwise noted, all pediatric dosing per AAP guidelines: AAP Committee on Drugs. Drugs for Pediatric Emergencies full text
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