Emergency Drug Doses for Infants and Children

This guideline for emergency drug dosing has been prepared for physicians requiring assistance with drug doses for pediatric patients. The drugs included are not intended to be exhaustive; therefore, this guideline should not be construed as an endorsement of the drugs selected. Information on drug indications and side effects has been purposely limited. In anticipation of future updates of this guideline, the Committee on Drugs invites comments and suggestions.

The following list has been prepared by the Committee on Drugs, with the assistance of the Committee on Pediatric Emergency Medicine. It represents the opinion of the Committees and may differ from information in package inserts of drugs. Doses should be individualized depending on patient response. These are general guidelines only. Physician judgment should be involved in the use of this emergency drug dose information.

Atropine Sulfate

Dose: SC—0.04 mg/kg IV or intratracheal—0.01-0.02 mg/kg per dose

WARNING: 0.04 mg/kg or 2 mg maximum total dose, whichever is smaller (except for anticholinesterase poisoning which may require larger doses)

Bicarbonate

Dose: IV—1 mEq/kg (Note: use only 0.5-mEq/mL solution for newborns

Note: The use of sodium bicarbonate should be based on documented metabolic acidosis; routine use in cardiac arrest is not recommended

Calcium Chloride

Dose: IV—0.15-0.3 mL/kg per dose (0.2-0.4 mEq/kg per dose). Inject slowly. Stop if bradycardia occurs

WARNING: Not to be given SO or IM

Form: 100 mg/mL, in 10-mL ampule on syringe; each 1 mL contains 1.36 mEq of elemental calcium

Note: Calcium is recommended for cardiac resuscitation only in cases of documented hypocalcemia