25kg (8yr)

Critical Care Quick Reference Group

Weight 25 kg
Age 8 years
Broselow Color Orange

Normal Vital Signs

Heart Rate 70 - 110 bpm
Respiratory Rate 18 - 22 rpm
Systolic BP 80-110 mmHg



Intubation

Medication Dose Calculation
Pretreatment
Lidocaine 38 mg 1.5 mg/kg[1]
Fentanyl 25 mcg 1 mcg/kg
RSI
Etomidate 7.5 mg 0.3 mg/kg
Succinylcholine 38 mg 1.5 mg/kg
Midazolam (Versed) 2 mg 0.1 mg/kg
(max 2 mg per dose)
Ketamine 50 mg 2 mg/kg
Vecuronium 2.5 mg 0.1 mg/kg
Rocuronium 25 mg 1 mg/kg
Equipment
ET Tube (cuffed) 5 ±0.5 age/4+3
Blade 3-4 Miller or MAC
cm to teeth 15 3 x ETT size

Pulseless Arrest

Medication Dose Calculation
Defibrillation 50 J 2 J/kg
(max 200)
Epinephrine (1:10,000) 0.25 mg 0.01 mg/kg
(max 1 mg)
Amiodarone load (without pulse) 125 mg 5 mg/kg
(max 300)
Lidocaine 25 mg 1 mg/kg
Lidocaine Infusion 1250 mcg/min 50 mcg/kg/min
Magnesium sulfate 1250 mg 50 mg/kg
(max 2000 mg)
CalCl (100mg/mL) 500 20 mg/kg
(max 1000 mg)
Sodium Bicarbonate (8.4%) 25mL 1 mL/kg
(max 50 mL)

Cardiac with Pulse

Medication Dose Calculation
Adenosine 2.5 mg 0.1 mg/kg
(max 6 mg)
Adenosine Repeat 5 mg 0.2 mg/kg
(max 12 mg)
Amiodarone load (with pulse) 125 mg 5 mg/kg
Amiodarone 2nd/3rd dose repeat loading dose up to total 3 times 15 mg/kg max
Atropine 0.5 mg 0.02 mg/kg
(max 1 mg)
Cardioversion First Shock 25 J 1 J/kg
Cardioversion Second Shock 50 J 2 J/kg
Procainamide 375 mg 15 mg/kg
(max 1500 mg)
Diltiazem 6.25 mg 0.25 mg/kg
Esmolol 2500 mcg/min 100 mcg/kg/min
Magnesium sulfate 1250 mg 50 mg/kg
Nitroglycerin drip 1.25 mcg 0.05 mcg/kg/min
Glucagon 0.63 mg 0.025 mg/kg

Hypoglycemia

Medication Dose Calculation
D25W 50 mL 2 mL/kg
D10 W 62.5 mL 2.5 mL/kg
Glucagon 0.63 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) 1.3 mg 0.05 mg/kg
(max 2 mg per dose)
Morphine 2.5 mg 0.1 mg/kg
Fenatnyl 25 mcg 1 mcg/kg
Ketamine 25 mg 1 mg/kg
Midazolam (Versed) 2 mg 0.1 mg/kg
(max 2 mg per dose)
Propofol IV (initial) 25 mg 1 mg/kg
Propofol (drip) 1250 mcg 50 mcg/kg/min

Seizure and CNS

Medication Dose Calculation
Lorazepam (Ativan) 1.3 mg 0.05 mg/kg
(max 2 mg per dose)
Fosphenytoin (PE = phenytoin equivalent) 500 PE 20 PE/kg
Phenytoin (Dilantin) 500 mg 20 mg/kg
Phenobarbitol 250 mg 10 mg/kg
Diazepam (Valium) rectal 2.5 mg 0.1 mg/kg every 2 min
Levetiracetam (Keppra) 500 mg 20 mg/kg
Mannitol 25 g 1 g/kg
Hypoglycemia IV dextrose see glucose table

Trauma

Medication Dose Calculation
Normal saline 0.9% bolus 500mL
PRBCs (1u=250mL) 1 unit
Chest tube (fr) 28
Central line 4-5F (IJ/subclavian)

5-8F (femoral)

NG tube (fr) 12

Equipment

Medication Dose Calculation
Chest tube (fr) 28
Central line 4-5F (IJ/subclavian)

5-8F (femoral)

NG tube (fr) 12

Fluids

Medication Dose Calculation
Normal saline 0.9% bolus 500mL 20 mL/kg
Maintenance 65mL/hr 4-2-1 Rule
PRBCs (1u=250mL) 1 unit

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)
Preemie 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