ocket Reference

UC

The 4-2-1 ule 4 cc/kg/hr for each kg up to 10 kg

to calculate
+ 2 cc/kg/hr for each additional kg up to 20 kg
hourly fluid

maintenance:

SF Childrens Hospital

atUCSFMedicalCenter

UCSF adaptation with

Oregon Health and Science University

Rachel Mercer, M.D.

ager

Office

3-1581
3-1815

443-2398

443-4669

ICN (15th Floor)

PCRC=3-1352

3-1484
3-1545
3-1965
3-1292
3-1028
3-1313
3-1352
3-1955
3-1565

eds Transitional Unit (7N)=3-9140 6L=3-1921

st

Heme-Onc (7L)=3-1631

2-4 J/kg (Max 200 J) = 3 + Energy Doses:

eplace the 1 of the pre-op volume deficit (Maintenance IVF x hrs

Neonate

1-2*

Neonate 2-3*
Neonate

>3

3.0

3.5
3.5-4.0

8 cm*

9 cm*
10 cm

Miller 0

Mil 0/Mil 1
Mil 0/Mil 1

1
1

<60

1-2 J/kg (Max 200 J synch) = 2

non-K containing crystalloid (LR is OK).

MAP

140s

30**
30s**

<60 130-140 30s**

<60

130-140

40s**

1-6 mo 4-6 3.5-4.0 12 cm Mil 1/Wis 1.5 1-1.5 24-30 130s

6mo-1yr 6-10
4.0 13 cm
Wis 1.5
1.5 22-26 130s
1-2 yr 10-12 4.5 14 cm
Wis 1.5
2 20-24 120s
2-4 yr 12-16

4-6 yr 16-20
6-8 yr 20-30
9-12 yr 30-45
>14 yr

>50

5.0

5.5
6.0

15 cm Wis 1.5/Mac 2

16 cm
17 cm

Mil 2/Mac2
Mil 2/Mac2

6.5-7.0 18 cm Mil/Mac 2-3

7.0

20-22

Mil/Mac 2-3

Neonatal Rules to Remember:

18-22

50s
60s
60s

110s

60s

2 16-20 90-110
2.5 16-20 90s

70s
70s

12-18

80

70-80s

10-16

75

70-80s

In General:

nd

0.25-0.5 J/kg (Max 100 J synch) = 1 Energy Dose

Blood Product Transfusion Guidelines

eplace
the prep
2nd loss,
ofetc)the
over
the remainder
of the procedure.
NPO + bowel
overdeficit
the 1 hour
of surgery
with
Fluid Boluses are typically 10-15 mL/kg/bolus for hypovolemic patients
Safety Tip: De-bubble your IV immediately prior to the case and
st

PRBCs: 10 mL/kg should raise Hct by 3-5%

PRBC units should be filtered, warmed, and followed by 0.9% NaCl (no Ca

do not fill the

buretrol withfor
>1-2
hrs worthand
of maintenance
fluid.
Glucose
equirements
Neonates
Infants

++)

under six months of age, especially during long procedures.

5.

FFP and PRBCs can be sent back if out of cooler < 30 minutes
Factor IX concentrate is the preferred treatment for Hemophilia B

1. Dental cases with manipulation or perforation of the gingiva or oral mucosa.

2. Respiratory tract procedures involving incision or biopsy of the mucosa.
3. Procedures involving infected skin or infected musculoskeletal tissue.

Platelets:
15 mL/kg should raise platelet count by 30-50,000
Keep at room temp, filter when used, & do not warm. Returnable if out < 4hrs.
Fibrinogen 100-150mg/dL (has Fact VIII & vWF)

Intraop glucose infusion is recommended for infants that are:

4. Septic
5. Suspected of having inborn errors

Humate is the preferred treatment for known VIII or vWF deficiencies

Hyperkalemia Treatments

Meals (Cereals)

Full Meals

Morphine

(stabilizes myocardium)

1. Calcium Chloride 10 mg/kg IV

+
(alkalosis+drives K intracellular)
2. Hyperventilation
3. NaHCO3 1 mEq/kg/dose IV
(drives K intracellular)

dry with

Estimated Blood Volume

Premature

90-100 mL/kg

Term Neonate

80 mL/kg

1 year old

75 mL/kg

(Glu cotransport w/K into cells)

+

5. Albuterol 5-20 mg via nebulizer (drives K intracellular)

6. Furosemide 1 mg/kg IV prn

(if renal function is normal)

7. Kayexalate 1-2 gms/kg PO/PR

(binds K in exchange for Na )

PROOF++

6. Vancomycin is approved for IE prophylaxis on high risk patients admitted for

Malignant Hyperthermia

7. NICU patients do not require vancomycin unless known to be MRSA +

Antibiotic IE Prophylaxis Regimen (all are single dose)

if forgotten, antibiotics may be given up to 2 hours post-procedure.

Standard: Amoxicillin 50 mg/kg IV/IM/PO max 2 gms (1hr prior if PO)
Cefazolin 50 mg/kg IV/IM max 1 gm
A

IV

*
30
min prior to
dminister
surgical
incision

Ampicillin 50 mg/kg IV/IM max 2 gms

50 mg/kg IV/IM max 1 gm

OR Ceftriaxone

PCN Allergic: Clindamycin 20 mg/kg IV/PO max 600 mg 1 hr prior

compared

Dose (mg) to Morphine

Hydromorphone 1.5
Methadone

4. D50 1 cc/kg + Insulin 0.2U/kg IV

Equipotent IV Potency

10

or who areagainst
undergoing
a non-elective
endoscopy.ampicillin,
Prophylaxispiperacillin,
should be vancomycin).
directed
enterococci
(amoxicillin,

>72 hours prior to surgery, or patients known to have MRSA colonization.

IV Opioid Conversions

Analgesic

5. IE prophylaxis is reasonable for at risk patients with active GI or GU infection,

Signs: Peaked T-waves on EKG, Wide QRS, Cardiac Arrest

room to administer IV meds.

Due to immature renal function, NaCl is not used on D L #1.

(IV)

or therapeutic endoscopy (banding, polypectomy, ERCP, etc.) except for:

-- GI or GU tract procedures involving contaminated or dirty/infected tissue

-- GI or GU tract procedures on patients septic due to GI or GU infection

Note: NPO inpatient neonates often arrive on D10 NaCl. Why?

Opioid

clean or clean-contaminated GI or GU tract procedure, including diagnostic

Keep at room temp & filter unless ordered prefiltered w/attached 60mL syringe

Glucose requirement

2
4

4. Antibiotic administration solely to prevent IE is NOT recommended for ANY

Request reconstituted in 10-15 mL per button with 0.9% NaCl or FFP

or Glucose / D10
6. Neonates born to diabetic mothers
The typical newborn basal glucose requirement is 5-8 mg/kg/min.
If in doubt, start at 5 and adjust as necessary. Fever, sepsis, shock,

Clears
Breast Milk
Formula, Milk, & Light

Indwelling transvenous (not epicardial) pacers or defibrillators

Procedures Requiring IE Prophylaxis in At Risk Patients

Cryo: 1 button/5 kg=

of metabolism / TCA cycle errors

NPO Guidelines (hours)

4. Heart transplant recipients

Infants < 4 mos old receive Neg, leukoreduced, irradiated, CMV neg
For > 60 mL/kg transfusion or cardiac cases, request < 5 day old PRBCs (RC-5)

FFP: 10 mL/kg as needed to improve PT/PTT (has Factors V, VII, & XI)

Consider intraop glucose administration to NPO infants

With D10 infusing glucose at 5 mg/kg/min, they will receive about

3
/4 of their hourly fluid maintenance, leaving them slightly

a. Uncorrected
or palliated
cyanotic CHD
(Glenn,
ontan,
etc.)
b.
Completely
repaired
CHD
with
prosthetic
material (patches,
stents, devices, and coils) within the first 6 months post-op
c. Repaired CHD with residual defects at or adjacent to the site of
a prosthetic patch or device

& Subsequent Energy Doses

Hx: ARF/CRF, Transfusions, Burns, Trauma, GI Bleeds, Hemolysis

HR

140s

3. Congenital Heart Disease (CHD):

st

prematurity, and maternal gestational DM =

At Risk Patient Conditions

2. Previous endocarditis
Synchronized Cardioversion: (unstable SVT, VTach, A fib/flutter)

3. Already on TPN

Endocarditis Prophylaxis Guidelines

patients without one of these conditions do not require ie abx prophylaxis .
1. Presence of a prosthetic or bioprosthetic valve, shunt, or conduit

Energy Dose:

rd

+ 1 cc/kg/hr for each additional kg above 20 kg

Pediatric Normal arameters and Equipment

Weight ETT ID ETT @ Laryngoscope LMA RR
AGE (kg)
(mm) Lips
Blade
Neonate <1*
2.5 7 cm*
Miller 0
1
<60

nd

1-2 J/kg (Max 200 J) = 1 or 2

(Thus, a 22 kg pt needs 40+20+2 = 62 ml/hr)

1. < 45 wks PCA

2. Premature / IUGR

cm

Defibrillation: (Ventricullar fibrillation and pulseless Vtach)

st

Card Design & Data Compilation by Daniel J. Woodward, M.D.

E1 Phone
Anesthesia Workroom:
Pain Service:
OR Front Desk:
Peds Pre-op / eds ACU
Adult PACU
Pharmacy Technician:
Blood Bank
PICU
Peds Cardiac ICU (7E)

Electrical Biphasic Countershock in Children

Maintenance Fluid equirement Calculation

07

cm

AHAOct

200 DJW
9

ediatric Anesthesia

1x
6.5x

or

*C

ephalosporins are

Signs: EtCO2, Muscle

Rigidity,= Hyperkalemia,
Sudden Cardiac
MH Hotline
1-800-MH-HYPER
Arrest, Arrythmias, Hyperthermia, Acidosis, Myoglobinuria

patients with true pcn

not recommended in
anaphylaxis due to

10% cross-reactivity

Cephalexin 50 mg/kg IV/PO max 2 gms*

or Cefazolin 50 mg/kg IM/IV max 1-2 gm *

or Vancomycin 20 mg/kg IV max 1 gm (over 30 min)

1. Call for help

MRSA +:

anesthesia machine, & expedite surgery completion if possible

2. Stop all potent inhaled anesthetics, convert to TIVA, exchange

Children ( 6 mo) Bupivacaine & Ropivacaine: Max Dose = 0.3-0.4 mg/kg/hr

2x

Vancomycin 20 mg/kg IV max 1 gm (over 30 min)

Epidural Infusion Doses & Rates

2009
DJW

Meperidine
Fentanyl

80
0.1

1/8x
100x

Alfentanil

0.5

20x

4. Hyperventilate with 100% O2 to normalize EtCO2

Sufentanil

0.02

500x

5.

3. Dantrolene 2 mg/kg IV per BP to 10 mg/kg (mix with sterile H2O)

Treat hyperkalemia (see treatments above)

Neonates (< 6 mo) Bupivacaine & Ropivacaine: Max Dose = 0.2 mg/kg/hr
*In neonates consider using Lidocaine infusion: Max Dose = 0.5-1 mg/kg/hr

Local anesthetic infusion RATES can be estimated: < 6 mo = 0.05 mL/kg

and > 6 mo = 0.04 mL/kg per dermatome to be covered. Suggested

** For preterm and term newborns, the

Adult

(or 5th finger size)

70 mL/kg

(or Age + 11 cm at lip)

larger and smaller diameter ET tubes are available at all times.

cm

MORPHI
NE

ETOMIDATE

ACTOR VIIa

ALBUTEROL

Nebulized: 2.5mg in 3ml q20 or continuous

ALFENTANIL

IV bolus: 10-50 mcg/kg IV

Infusion: 1-3 mcg/kg/min IV

C B prime. 30-75 mg/kg/hr infusion.

(Cordarone)

5 mg/kg IV load (max 150mg) over 30

then 5-10 mcg/kg/min.

ATROPINE

IV: 10-20 mcg/kg IV

(Cafcit)

2/3 of initial dose q 90-120

20 mg/kg IV (as Citrate) or 10 mg/kg IV

(as Caffeine Base) for apnea prophylaxis

CALCIUM CHLORIDE 5-10 mg/kg IV slowly. Arrest = 10 mg/kg IV

CIS-ATRACURIUM
0.1-0.2 mg/kg IV for paralysis in 1-2 min
(Nimbex)

Codeine

(Dose elixer per codeine)

20-40 min until reversible

(Hoffman)
Max = 60 mg/dose q6o
0.5-1 mg/kg
Elixer= 12mg Codeine / 120mg A AP / 5ml

DANTROLENE

2 mg/kg/dose to max of 10 mg/kg q6o

DESMOPRESSIN

Hemophilia: 0.3 mcg/kg IV slowly

Diabetes Insipidus: 1-2 mcg IV/SQ q 12
0.2-1 mcg/kg/hr IV infusion

(bottled w/Mannitol)
(DDAVP )

DEXMEDETOMIDINE

U OSEMIDE

NALOXONE
(Narcan )

0.3 mg/kg IV (full induction)

NEOSTIGMINE

Maintenance: 5-20 mcg/kg/min (t=75min)

90 mcg/kg q 2o until hemostasis achieved
Get Heme consult.

0.5-1 mg/kg/dose IV/IM q 6-12

OCO TISONE

mg/day (<1 y/o = 25-150 mg/day) q6-8

OMO PHONE

IV: 5-10 mcg/kg IV

(Dilaudid )

(see Malignant Hyperthermia algorithm)

o

PO/P : 50-80 mcg/kg q 3-6 prn

IBUP OFEN
INT ALIPID
KETAMINE

(Ketalar )

End-case sleepy: 0.5-1 mcg/kg IV prn

VASOPRESSIN

Adult VF/VTACH Arrest: 40 U IV x 1 dose

Opioid Intoxication: 10 mcg/kg IV/IM/ETT

(Pitressin )

Peds Infusion: 0.3-2 milliunits/kg/min IV

(P STIGMIN )

NICARDIPINE

20 mcg/kg or glycopyrrolate 15 mcg/kg IV

Adult loading dose: 5 mg IV over 5-10 min
Infusion: 2.5-15 mg/hr or 0.5-5 mcg/kg/min

(CARDENE )

6-10 mg/kg PO max 800mg q 8 hrs prn

1-2 mL/kg IV (acute local anesth. toxicity)
IV induction: 2-3 mg/kg (see Sedatives)
IM (full) induction: 5-8 mg/kg

4-12 mcg/kg/min IV (preemptive analgesia)

Single Shot Caudal Opioids: Morphine 50 mcg/kg or Hydromorph 5-10 mcg/kg

30-70 mcg/kg IV. Max=5 mg. Add atropine

(-t = 2-5 min, -t = 45 min)

0.5-20 mcg/kg/min IV infusion
0.5-20 mcg/kg/min IV infusion
0.05-0.1 mcg/kg/min IV Max=2 mcg/kg/min
N NDANSETR
REPINEPHRINE
0.15 mg/kg IV max 4mg for
NV
N
(Zofran)
Give 30 min prior to end of surgery
: 0.1 mg/kg q3-6o prn
XYC D NE
0.1 mg/kg IV for full paralysis in 3 min
ANCUR NIUM
(Pavulon)
60-90 min until reversible (80% Renal)
HEN BARBITAL
Status Epilepticus: 15-20 mg/kg SL W IV
(Luminal)
then add 5 mg/kg q 20 Max = 30 mg/kg IV
0.5-1 mcg/kg IV bolus prn hypotension
HENYLEPHRINE
(Neosynephrine)
0.1-0.5 mcg/kg/min IV titrated infusion
Loading dose: 15-20 mg/kg IV over 30 min
HENYT IN
(Dilantin)
(Do not exceed 0.5 mg/kg/min IV)
0.5-1 mEq/kg slow IV infusion
TASSIUM
/IM/PR/IV q 6-8o
CHL RPERAZINE 0.1-0.15 mg/kg
(Compazine)
Max = 10mg/dose
IV/P /PR/IM: 0.25-0.5 mg/kg q 6-8o prn
METHAZINE
(Phenergan)
Max = 25 mg/dose. (Not for kids < 2y/o)

NITR
NITR

Hydromorphone or Morphine may be appropriate.

cm

Analgesia: 0.5-1 mcg/kg IV

Infusion: 1-5 mcg/kg/hr IV

maximum dose and a 1 hr limit (w/boluses) below the maximum dose.

Consider addition of opioids to LA solution: Fentanyl 2 mcg/ml (fixed) is typical

5-8
mg/kg IV
(full
induction
)

TAL

0.02 mg/kg IV prn benzodiazepine reversal

GLUCAGON
0.1 mg/kg IV Max = 1mg
GLYCOPY OLATE
NMB eversal: 0.01-0.15 mg/kg IV
( obinul)
Antisialogogue: 0.05-0.2 mg IV/IM
VIII Deficiency: 40-60 U/kg IV then 20-30

HUMATE
U/kg IV q8hrs (in severe dz w/major surg)
( VIII+vWF complex)
vWF Deficiency: 40-80 U/kg IV then 40-60
U/kg q8hr (Types 2 & 3) or q24hr (Type 1)
GET HEME CONSULT
Stress Dose: 1-2 mg/kg IV then 150-250

HYD
HYD

10. Maintain 2 cc/kg/hr urine output (with diuretics if necessary)

0.5 mg/kg IV bolus prn IV

50-150 mcg/kg/min IV infusion

LUMAZENIL

st

CAFFEINE

8. Arterial Line: ABG, Lytes, Ca++, CPK, AST/ALT, CK, Myoglobin

9. Sodium Bicarbonate per ABG acidosis

THIOPEN

( omazicon)

IM/ O: 20-30 mcg/kg IM

Repeat Dose:

(Sublimaze)
(Lasix)

BUPIVACAINE 0.25% Caudal: 1 Dose = 0.5-1 cc/kg

(w/1:200,000 epi)

(NovoSeven )

ENTANYL

AMINOCAPROIC ACID 75 mg/kg (max 5 gm) dilute IV load and in

AMIODARONE

Analgesi
a: 0.050.1
mg/kg/d
ose
IV/IM

pediatric rates: < 6 mo = 0.1-0.2 mL/kg/hr, > 6 mo = 0.1-0.4 mL/kg/hr.

Calculate the Max dose of LA and consider a basal rate equal to HALF this

7. Cold IV fluids, gastric/peritoneal/bladder/rectal cold lavage

monitoring. Discuss with the anesthesia attending prior to D/C.

IV: 0.10.2
mg/kg
prn
Ephedrin hypoten
e
sion /
2009 DJW
brady
MEDICATIONS: ALL IV DRUGS MAY BE GIVEN IO
ACETAMINOPHEN
PO or IV: 10-15 mg/kg
Esmolol
(Breviblock )
(APAP, Tylenol)
PR: 40 mg/kg (next PO/IV/PR dose in 6 hr)
ADENOSINE
0.1-0.2 mg/kg fast IV push with flush

(Amidate )
May repeat at 0.2 mg/kg IV after 2 min
(Adenocard )

(Amicar)

6. Avoid Calcium Channel Blockers for dysrhythmias

100x

Infants <56 wks PCA with risk factors for apnea may require post-op

Make sure that various sized laryngoscope blades as well as

(Alfenta)

0.1

Neonatal / Infant Post-Op Observation

MAP is equal to the # of weeks PCA! ETT Depth: 3 x ETT Size

By DOL 5, MAP = # of weeks PCA + 5

Remifentanil

GLYCERINE
PRUSSIDE

(Diprivan)

Induction: 2-3 mg/kg (higher in children)

Infusion: 50-250 mcg/kg/min

Diabetes Insipidus: 0.5-10 milliunits/kg/hr

VECUR

NIUM

0.1 mg/kg IV for full paralysis in 2-3 min

30-45 min until reversible (80% Hepatic)

(Norcuron)

Parenteral Antibiotic Initial & 24hr Dosages

SEE REFERENCE TEXT F

R PREMIE, TERM NEONATAL, AND IN ANT DOSAGES

ANTIBI TIC
Ampicillin

INITIAL DOSE
24 TOTAL DOSE
INTERVAL
25 mg/kg
100-400 mg/kg max 12 gm Q4-6

Cefazolin
Cefotetan

25-50 mg/kg 50-100 mg/kg max 12 gm Q6-8

25 mg/kg
40-80 mg/kg max 6 gm
Q12

Cefoxitin

20-40 mg/kg 80-160 mg/kg max 12 gm

Q6-8

Cefuroxime
Ciprofloxacin
Clindamycin
Gentamicin
Metronidazole

10 mg/kg
10-15 mg/kg
1.5 mg/kg
15 mg/kg

20-30 mg/kg max 800 mg

25-40 mg/kg max 1800 mg
6-7.5 max mg/kg/day
30 mg/kg max 4 gm

Q12
Q6-8
Q8-12
Q6

25 mg/kg

100-200 mg/kg max 12 gm Q6

xacillin

Vancomycin

25-50 mg/kg 75-150 mg/kg max 6-9 gm Q6

10-15 mg/kg* 40 mg/kg max 2gm

CNS infection:

15 mg/kg*

60 mg/kg *OVER 30 MIN*

Q8-12
per & T

Pre-Operative Sedatives
CHL RAL HYDRATE
DIAZEPAM
(Valium)

KETAMINE

: 50-75 mg/kg
: 0.25-0.5 mg/kg Max = 20 mg
IV: 0.1 mg/kg/dose
IM:

Midazolam
0.1-0.220mg/kg
to stun prior to IV
3-5 mg/kg w/Atropine
mcg/kg and

(Precedex)

DEXAMETHASONE
(Decadron)

DEXTROSE (50%)
DEXTROSE (50%)
w/INSULIN

DIPHENHYDRAMINE

0.2-1 mcg/kg IV load (over 10-20 min)

Airway Edema: 0.25-0.5 mg/kg IV q6o
IC : 0.5-1.5 mg/kg then 0.2-0.5 mg/kg/day
0.5 gm/kg = 1 cc/kg of D50
0.5 gm/kg Dextrose + 0.2 U/kg Insulin
This is a stat and hourly dose.
o

KETO OLAC
(Toradol)

LABETALOL

LIDOCAINE
MAGNESIUM SO4

MANNITOL
(Osmitrol)

METHADONE
METHYLPREDNISILONE

(Benadryl)
DOBUTAMINE

0.5-1 mg/kg IV q 4-6 Max 50mg IV/dose

0.5-20 mcg/kg/min IV infusion

DOPAMINE

0.5-20 mcg/kg/min IV infusion

EPINEPHRINE

Arrest: 10 mcg/kg IV/ETT

Vasopressor: 0.5-5 mcg/kg IV

(Adrenalin)

Infusion: 0.02 - 1 mcg/kg/min IV

METOCLOPRAMIDE

Racemic 2.25% solut. 0.25-0.5 ml via neb

(Reglan)

0.5-1 mg/kg IV then 0.5 mg/kg q 6

0.1 mg/kg IV increments q 5-10 min per BP
1-1.5 mg/kg IV/ETT
25-50 mg/kg/dose IV (watch hypotension)
0.25-1 gram/kg IV (typically) slowly
Maintenance: 0.25-0.5 gm/kg IV q 4-6o
0.05-0.1 mg/kg PO/IM/IV/SQ t=18-24 hrs

(Solu-Medrol)

Asthma: 2 mg/kg then 2 mg/kg/day q 4-6

MILRINONE

Load: 25-50 mcg/kg IV over 15 min

Maintenance: 0.25-1 mcg/kg/min IV

(Primacor )

0.1-0.15 mg/kg IV/PO q 6 prn

ANITIDINE (Zantac)
EMIFENTANIL

(Ultiva)

PROOF

CUR NIUM

(Zemuron)
ROPIVACAINE 0.2%
(w/1:200,000 epi)

IV: 1 mg/kg
: 2mg/kg (30min pre-induction)
IV Infusion: 0.05-0.5 mcg/kg/min IV
IV Bolus: 0.5-1 mcg/kg IV
0.6-1.2 mg/kg IV for paralysis in 1-2 min

20-40 min until reversible (80% Hepatic)

st

(Ketalar)
(Ativan)

IV/IM/PO: 0.05 mg/kg/dose

METHOHEXITAL PR: 25-30 mg/kg max 600mg (for 20kg patient)

Oral: 0.25-0.5 mg/kg Max20mg
10-15 mg/kg acetaminophen syrup

Caudal: 1 Dose = 0.5-1 cc/kg

Repeat Dose: 2/3 of 1st dose q 90-120

0.02 mg/kg IV max 0.4 mg

Note:
Usewith
concentrated
5 mg/ml
: 4-6 mg/kg
Midazolam syrup
as belowmidazolam

L RAZEPAM

SCOPOLAMINE
SODIUM BICARBONATE 1-2 mEq/kg or per ABG

MIDAZOLAM
(Versed )

SUCCINYLCHOLINE

IV: 1-2 mg/kg for full paralysis in 30 sec

(Quelicin)

IM: 4 mg/kg max 5ml at injection site

PENTOBARBITAL IV: 1-6 mg/kg (varies upon procedure duration)

SUFENTANIL
(Sufenta )

TERBUTALINE

Rectal: 0.5-1.0 mg/kg diluted to 3ml saline

Intranasal: 0.2-0.3 mg/kg (use nasal atomizer)

IM: 0.25 mg/kg (be wary of injection site pain)
IV:

Analgesia: 0.5-2 mcg/kg IV

Typical: 10-20 mcg/kg total dose

5-10 mcg/kg IV q 15 (max 250 mcg)

0.05-0.1 mg/kg/dose to max of 0.25 mg/kg

Disclaimer: The author is not responsible for errors. Every effort has been made to ensure that the

information provided in this reference card is accurate and in accordance with currently accepted medical

practice standards. It

remains the responsibility of the physician to evaluate the appropriateness of

a particular therapy or intervention in the context of each clinical situation with consideration to their
knowledge, skill, and practice standard changes since this cards publication.
2009 DJW

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