PICU CALCULATOR
Affix patient label
 
kg

AIRWAY & DEFIB

ETT size:__
ETT depth:__
Laryngoscopy blade:__
LMA size:__
Defibrillation (2-4J/kg): __ to __J
Sync.Cardioversion (0.5→1→2J/kg): __→ __→ __J

INTUBATION MEDICATIONS

Ketamine (1mg/kg):
Preparation=10mg/ml
 ___ mg = __ ml
Midazolam (0.1mg/kg):
Preparation=5mg/ml
Max dose=5mg
 ___ mg = __ ml
Fentanyl (1microgram/kg):
Preparation=50microgram/ml
Max dose=100microgram
 ___ microgram = __ ml
Morphine (0.1mg/kg):
Preparation=15mg/ml
Max dose=10mg
 ___ mg = __ ml
Etomidate (0.3mg/kg):
Preparation=2mg/ml
Max dose=20mg
 ___ mg = __ ml
Propofol (1mg/kg):
Preparation=10mg/ml
 ___ mg = __ ml
Rocuronium (1mg/kg):
Preparation=10mg/ml
 ___ mg = __ ml
Suxamethonium (1.5mg/kg):
Preparation=50mg/ml
Max dose=100mg
 ___ mg = __ ml
Neostigmine (0.05mg/kg):
Preparation=2.5mg/ml
Max dose=2.5mg
 ___ mg = __ ml
Sugammadex (16mg/kg):
Preparation=100mg/ml
 ___ mg = __ ml
Atropine (0.02mg/kg):
Preparation=0.6mg/ml
Min dose=0.1mg, Max dose=Child: 0.5mg/Adolescent: 1mg
 ___ mg = __ ml

EMERGENCIES

Adrenaline 1:10,000 IV/IO (0.01mg/kg):
for CARDIAC ARREST (use 1:10,000 formulation, 0.1mg/ml)
Max dose=1mg
__ mg = __ ml
Adrenaline 1:1,000 ET (0.1mg/kg):
for CARDIAC ARREST (use 1:1,000 formulation, 1mg/ml)
Max dose=2.5mg
 __ mg = __ ml
Adrenaline 1:1,000 IM (0.01mg/kg):
for ANAPHYLAXIS (use 1:1,000 formulation, 1mg/ml)
Max dose=Prepubertal:0.3mg/Adolescent:0.5mg
 __ mg = __ ml
Atropine (0.02mg/kg):
Preparation=0.6mg/ml
Min dose=0.1mg, Max dose=Child: 0.5mg/Adolescent: 1mg
 __ mg = __ ml
Amiodarone (5mg/kg):
Preparation=50mg/ml
Max dose=300mg
 __ mg = __ ml
ATP (0.167mg/kg):
Preparation=10mg/ml
Max dose=20mg
 __ mg = __ ml
Calcium gluconate 10% (0.5ml/kg):
Max dose=20ml
 __ ml
Dextrose (D10) (2.5ml/kg):
Infants & young children
Max dose=250ml
 __ ml
Dextrose (D50) (0.5ml/kg):
Older children & adolescents
Max dose=50ml
 __ ml
Flumazenil (0.01mg/kg):
Preparation=0.1mg/ml
Max dose=0.2mg
 __ mg = __ ml
Lignocaine 2% (1mg/kg):
Preparation=20mg/ml
 __ mg = __ ml
Lorazepam (0.1mg/kg):
Preparation=2mg/ml
Max dose=4mg
 __ mg = __ ml
Midazolam (0.1mg/kg):
Preparation=5mg/ml
Max dose=5mg
 __ mg = __ ml
MgSO4 50% (40mg/kg):
Preparation=2500mg/5ml
Dilute 3x with D5 (make up to __ml with D5)
Max dose=2000mg
 __ mg = __ ml
Naloxone (0.1mg/kg):
Preparation=0.4mg/ml
Max dose=2mg
 __ mg = __ ml
NaHCO3 8.4% (1ml/kg):
Max dose=100ml
Slow IV over 5-10mins
 __ ml
Procainamide (15mg/kg):
Preparation=100mg/ml
Dilute 5x with D5 (make up to __ml with D5)
Max dose=1000mg
 __ mg = __ ml
  • INOTROPES
  • Desired rate
  • Infuse at
  • Dose range
  • Dopamine
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 5-20 microgram/kg/min
  • Dobutamine
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 5-20 microgram/kg/min
  • Adrenaline
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.01-0.4 microgram/kg/min
  • Adrenaline (High Conc.)
  • __mg make up to 50ml with NS (High Conc.)
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.4-1 microgram/kg/min
  • Noradrenaline
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.01-0.4 microgram/kg/min
  • Noradrenaline (High Conc.)
  • __mg make up to 50ml with NS (High Conc.)
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.4-1 microgram/kg/min
  • Milrinone
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.3-1 microgram/kg/min
  • Vasopressin
  • __units make up to 50ml with NS
  • Desired rate:
  •  units/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.01-0.12 units/kg/h
  • SEDATION & PARALYSIS
  • Desired rate
  • Infuse at
  • Dose range
  • Fentanyl
  • __microgram make up to 50ml with D5
  • Desired rate:
  •  microgram/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 1-4 microgram/kg/h
  • Morphine
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 10-40 microgram/kg/h
  • Midazolam
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.5-20 microgram/kg/min
  • Ketamine
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 1-10 microgram/kg/min
  • Dexmedetomidine
  • __microgram make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.2-1 microgram/kg/h
  • Rocuronium
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 5-15 microgram/kg/min
  • Thiopentone
  • __mg make up to 50ml with NS
  • Desired rate:
  •  mg/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 1-5 mg/kg/h
  • ANTI-HYPERTENSIVES
  • Desired rate
  • Infuse at
  • Dose range
  • Labetalol
  • Undiluted (__mg/50ml)
  • Desired rate:
  •  mg/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.25-3 mg/kg/h
  • Esmolol
  • Undiluted (__mg/50ml)
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 25-300 microgram/kg/min
  • Nitroprusside
  • __mg make up to 50ml with D5
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.5-10 microgram/kg/min
  • ANTI-ARRHYTHMICS
  • Desired rate
  • Infuse at
  • Dose range
  • Amiodarone
  • __mg make up to 50ml with D5
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 5-15 microgram/kg/min
  • Lignocaine
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 15-50 microgram/kg/min
  • Procainamide
  • __mg make up to 50ml with D5
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 20-80 microgram/kg/min
  • Isoprenaline
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.05-1 microgram/kg/min
  • OTHERS
  • Desired rate
  • Infuse at
  • Dose range
  • Ventolin
  • __mg make up to 50ml with NS
  • Desired rate:
  •  microgram/kg/min
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 1-5 microgram/kg/min (Max 20microgram/min = 2.4ml/h)
  • Aminophylline
  • __mg make up to 50ml with NS
  • Desired rate:
  •  mg/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.5-1 mg/kg/h
  • Lasix
  • __mg make up to 50ml with NS
  • Desired rate:
  •  mg/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.25-1 mg/kg/h
  • Actrapid
  • __units make up to 50ml with NS
  • Desired rate:
  •  unit/kg/h
  • Infuse at:
  • __ ml/h
  • Dose range:
  • 0.05-0.1 units/kg/h
PICU Calculator () / Paedicalc.org
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Verbalise indication for intubation
Wear full PPE
Introduce team members
Allocate roles
  • Team leader
  • 1st intubator
  • 2nd intubator
  • Intubator assistant
  • Drugs
  • Documents
  • Monitor
PRN roles
  • Cricoid pressure
  • Manual in line stabilisation
Airway plan
1.
 

2.
 

3.
 
If difficult airway anticipated, refer to difficult airway algorithm
Difficult airway?
Date
 
Grade
 
on DL / VL
Blade
 
 
Position the head
Stable haemodynamics?
If unstable, start inotropes before intubation
Optimise preoxygenation
Assess aspiration risk
Drugs
1. Premedication
2. Sedatives x 2 doses
3. Paralytic x 2 doses
Others
Universal
Fill in by doctor
 

SPECIFIC ASPECTS

Pulse check:
Child: Carotid or femoral pulse
Infants: Brachial pulse
Compression-ventilation ratio:
30:2 for 1 rescuer
15:2 for 2 rescuers
Compression depth:
Child: 1/3 AP diameter of chest / 5cm
Infants: 1/3 AP diameter of chest / 4cm
Hand placement:
Child: 2 hands at lower half of sternum
Infants: 2 thumb-encircling hands at centre of chest
During CPR: Push hard and fast (100-120/min), allow full chest recoil, minimize interruptions, avoid hyperventilation, rotate compressor every 2 minutes
Consider advanced airway (endotracheal intubation or supraglottic advanced airway). Waveform capnography to confirm placement. With advanced airway: give 1 breath every 2-3 sec (20-30 breaths/min) with continuous chest compressions.
Reversible causes: Hypovolemia, hypoxia, hydrogen ion, hypoglycemia, hypo or hyperK+, hypothermia, tension pneumothorax, cardiac tamponade, pulmonary thromboembolism, coronary thrombosis, toxins
Prescribed by: ____________________________  (Signature)  ____________________  (Name)
Date and Time: