Emergency drugs (PICU Chart)
| Drug | Dose (IV) | Comment |
| Adenosine | 0.1 mg/Kg (Max dose: 6 mg) IV |
Give rapidly No effect in 2 min: 0.2–0.3 mg/Kg (Max dose: 12mg) |
| Albuterol | MDI: 4–8 puffs q 20 min with spacer or through ETT Neb: 2.5 mg (<20 Kg) and 5 mg (> 20 Kg) q 20 min Continuous Neb: 0.5 mg/Kg/hr |
Asthma, Anaphylaxis, Hyperkalemia |
| Amiodarone | 5 mg/Kg IV/IO* | Give rapid bolus for V. Fib/pulseless VT Give over 20–60 min for SVT and ventricular dysrhythmias |
| Atropine | 0.02 mg/Kg IV (may give ETT) |
Max dose: 0.5 mg (child) 1 mg (adolescent) |
| Calcium Chloride 10%** | 20 mg/Kg IV | Give slowly (Max. rate 100 mg/min) Max dose: 1 Gm/dose Give in central line if available** |
| Dexamethasone | 0.6 mg/Kg PO/IM/IV | Max dose: 16 mg |
| Dextrose | 500 mg/Kg IV | 1–2 ml/Kg D50W Child 2–4 ml/Kg D25W Infant 2–3 ml/Kg D10W NICU |
| Epinephrine (Anaphylaxis) | Anaphylaxis IM: 0.01 mg/Kg (0.01 ml/Kg) 1:1,000 |
Anaphylaxis Max dose: 0.3 mg or 0.3 ml |
| Epinephrine (Code) |
PICU/PEDS NICU |
Repeat q 3–5 min. for code |
| Epinephrine (Racemic) | 0.25–0.5 ml racemic solution (2.25%) mixed in 3 ml saline via inhalation 3 ml of 1:1000 epinephrine mixed with 3 ml saline via inhalation is alternative if racemic epi not available |
Croup |
| Flumazenil | 0.01 mg/Kg IV (Max dose: 0.2 mg) |
Give over 15 seconds May repeat at 1 minute intervals up to 4 times Max total dose: 0.05 mg/ Kg or 1 mg, whichever is lower |
| Furosemide | 0.5–1 mg/Kg IV | Congestive heart failure Use lower dose in furosemide naive patients |
| Hydrocortisone | 2 mg/Kg IV bolus | Adrenal insuffi ciency, catecholamine refractory shock |
| Insulin (regular) | 0.05–0.1 Units/Kg bolus IV or SQ 0.05–0.1 Units/Kg/hr infusion |
Diabetic Ketoacidosis (Infusion preferred to bolus dosing) |
| Lidocaine 2% | 1 mg/Kg IV/IO* | May repeat dose in 10–20 min. |
| Magnesium Sulfate | 25 mg/Kg IV/IO* | Give over 10–20 min; faster in Torsades de Pointes Max dose: 2 Gm |
| Methylprednisolone | 2 mg/Kg IV/IO/IM | Status Asthmaticus, Anaphylaxis Max dose: 60 mg; use only acetate salt for IM |
| Naloxone | 0.01 mg/Kg IV/ET | Titrate to effect Max dose: 2 mg |
| Nicardipine | 0.5–4 mcg/Kg/min IV | Hypertensive urgency/Emergency |
| Sodium Bicarbonate | 1 mEq/Kg IV | Use 1 mEq/ml for > 6 months Use 0.5 mEq/ml for < 6 months |
| Terbutaline | 10 mcg/Kg SQ q 15 min 0.1–10 mcg/Kg/min IV |
Refractory status Asthmaticus Max dose: 0.4 mg |
| Vasopressin | 0.5 units/Kg IV/IO* | Max dose: 40 units |
** Central line preferred
*** Central line preferred, but short duration peripheral IV acceptable