http://www.nelh-ec.warwick.ac.uk/NELH-EC_home.htm
For more information on dosages use Medicines for Children (http://www.rcpch.ac.uk/library/Formulary/formulary.htm)
>British National Formulary – current edition – Alder Hey ABCD of Childrens Doses 1994 with amendments 1996 -Braselow Tape – British Association of Emergency Medicine Guidelines for Children in the Accident and Emergency Department. -Advanced Paediatric Life Support- A practical approach BMJ Publishing
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Sarah Crowther – Valerie Madden (B. Pharm M.R .Pharm S. Paediatric Pharmacist.)
DISCLAIMER – It is the individual’s responsibility to double-check all doses in this guideline and ensure they are correct.
WHO Library Cataloguing-in-Publication Data Persisting pain in children package: WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses. Contents: WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses – Three brochures with important information for physicians and nurses; pharmacists; policy-makers and medicines regulatory authorities, hospital managers and health insurance managers – Dosing card – Pain Scale for children (4 years of age and up) – Pain Scale for children (6 – 10 years) – Wall chart for waiting rooms 1.Pain – drug therapy. 2.Pain – classification. 3.Pain measurement. 4.Analgesics, Opioid. 5.Drugs, Essential. 6.Drug and narcotic control. 7.Palliative care. 8.Child. 9.Guidelines.[Lire] |
All Drugs and Fluids should be calculated according to childs weight.
Quick weight calculation = 2 x (age + 4) or use dose according to approximate weight on charts
Ibuprofen
Morphine sulphate oral solution- Oramorph (10mg/5ml)
Trimeprazine (Vallergan)
Pethidine I.V.
Morphine I.V.
Lignocaine 1% (10mg in 1ml)
Entonox (50% Oxygen, 50% Nitrous oxide)
Salbutamol (for nebulisation)
Antibiotic doses
Codeine phosphate (pain relief dose)
Naloxone (Narcan)
Mannitol 20% (2g in 10ml)
Hydrocortisone
Paraldehyde
Aminophylline
Diazepam
Diazemuls
Phenobarbitone
Phenytoin
Liquid 120mg in 5ml Tablets 500mg
(Quick weight calculation =2 (age + 4))
Stat. Dose 15mg/kg. Doses at least 4 hours apart and no more than 4 in 24 hours
Check time of previous doses at home.
Make sure an effective dose is given.
AGE | APPROX WEIGHT | DOSE |
6 MONTHS | 5 kg | 60mg (2.5 ml) |
1 YEAR | 10kg | 120mg (5ml) |
3 YEARS | 15kg | 180mg (7.5 ml) |
5 YEARS | 20kg | 240mg (10ml) |
10 YEARS | 30kg | 360mg (15ml) |
12 YEARS | 40kg | 480mg (20ml)
or 500mg (tab) |
15 YEARS | 50kg | 1000mg (tabs) |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Liquid 100mg in 5ml Tablets 200mg
(Quick weight calculation = Twice age +8)
Stat dose 5mg/kg
Repeat 4 to 6 hourly. No more than 4 doses in 24 hours
AGE |
APPROX WEIGHT |
DOSE |
May only be prescribed by senior medical staff if patient less than 1 year old |
||
1 YEAR |
10kg |
50mg (2.5ml) |
3 YEARS |
15kg |
75mg (3.75ml) |
5 YEARS |
20 kg |
100mg (5ml) |
10 YEARS |
30kg |
150mg (7.5ml) |
12 YEARS |
40 kg |
200mg (10ml) |
15 YEARS |
50 kg |
200mg to 400mg (tablets) |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Morphine Sulphate Oral Solution
Oramorph (10mg/5ml)
(Quick weight calculation =2 (age + 4)
Stat dose 200 microgrammes to 400 microgrammes per kg
Measure doses with oral syringe.
AGE |
APPROX WEIGHT |
DOSE |
NOT RECOMMENDED UNDER 2 YRS OLD WITHOUT SENIOR MEDICAL STAFF CONSENT |
||
1 YEARS |
10 kg |
2mg (1ml) |
3 YEARS |
15 kg |
3 mg (1.5ml) |
5 YEARS |
20 kg |
4 mg (2ml) |
10 YEARS |
30 kg |
6 mg (3ml) |
12 YEARS |
40 kg |
8mg (4ml) |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Liquid 7.5mg in 5ml Tablets 10mg
(Quick weight calculation =2 (age + 4))
Sedative: Stat dose 1 to 2 mg/kg.(may need up to 3mg/kg)
AGE |
APPROX WEIGHT |
SEDATIVE DOSE |
NOT RECOMMENDED UNDER 6 MONTHS. |
||
6 MONTHS |
5 kg |
5 to 10 mg |
1 YEAR |
10 kg |
10 to 20 mg |
3 YEARS |
15 kg |
15 to 30 mg |
5 YEARS |
20 kg |
20 to 40mg |
10 YEARS |
30 kg |
30 to 60 mg |
12 YEARS |
40 kg |
40 to 80 mg |
15 YEARS |
50 kg |
50 to 100 mg |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
50 mg/ml or 100mg/2ml injection ampoules
Dilute in sodium chloride 0.9% before administration to make a solution of pethidine 50mg in 5ml i.e. 10mg in 1ml
(Quick weight calculation =2 (age + 4))
Stat Dose 0.5 to 1mg/kg. Give over 2 to 5minutes.
Doses can be repeated after 4 hours.
Monitor respiration , SaO2 and ECG
AGE |
APPROX WEIGHT |
SINGLE DOSE |
6 MONTHS |
5 kg |
5 mg |
1 YEAR |
10 kg |
10mg |
3 YEARS |
15 kg |
15 mg |
5 YEARS |
20 kg |
20 mg |
10 YEARS |
30 kg |
30 mg |
12 YEARS |
40 kg |
40 mg |
15 YEARS |
50 kg |
50 mg |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Morphine 10mg in 1ml
Dilute in Sodium chloride 0.9% to 10mg in 10ml ie 1mg in 1ml to titrate
Give slowly IV over 10 minutes.
(Quick Weight calculation =2 (age + 4))
Monitor respirations, SaO2 and ECG.
Dose varies according to age
Stat dose 100 to 200microgrammes/kg over 1 year old.
Stat dose 50 microgrammes/kg 3 to 6 months.
Stat dose 25microgrammes /kg 1 to 3 months.
Give slowly over 5 to 10 minutes. Start with lower dose
AGE |
APPROX WEIGHT |
DOSE |
6 MONTHS |
5 kg |
0.25mg |
1 YEAR |
10 kg |
1 to 2 mg |
3 YEARS |
15 kg |
1.5 to 3mg |
5 YEARS |
20 kg |
2mg to 4mg |
10 YEARS |
30 kg |
3 to 6mg |
12 YEARS |
40 kg |
4 to 8mg |
15 YEARS |
50 kg |
5 to 10mg |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Lignocaine 1% (10mg in 1ml)
(Local anaesthetic)
Available as 2ml and 5ml ampoules
(Quick weight calculation =2 (age + 4))
Maximum safe dose is 3mg/kg by local infiltration repeated after 4 hours.
(1% Lignocaine contains 10mg/ml.)
AGE |
APPROX WEIGHT |
DOSE OF LIGNOCAINE |
VOLUME OF LIGNOCAINE 1% |
6 MONTHS |
5 kg |
15mg |
1.5ml |
3 YEARS |
10 kg |
30mg |
3 ml |
5 YEARS |
15 kg |
45mg |
4.5ml |
10 YEARS |
20 kg |
60mg |
6 ml |
12 YEARS |
30 kg |
90mg |
9 ml |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Entonox (50% oxygen, 50% Nitrous Oxide)
For use in children over 5 years old, must be patient administered.
Mouthpiece must be used for young child.
May be used whilst achieving intravenous access, performing as nerve block, moving a fractured limb in to a splint.
Contraindicated in children with:
A pneumothorax until drained.
Head injury.
Facial injury.
Decompression sickness.
CTITU Medias.
for nebulisation
(Quick weight calculation = 2 ( age + 4))
AGE |
APPROX WEIGHT |
DOSE |
6 MONTHS |
5 kg |
1.25 mg |
1 YEAR |
10 kg |
1.25mg |
3 YEARS |
15 kg |
2.5 mg |
5 YEARS |
20 kg |
2.5mg |
10 YEARS |
30 kg |
2.5 to 5mg |
12 YEARS |
40 kg |
2.5 to 5mg |
15 YEARS |
50 kg |
2.5 to 5mg |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
(Quick weight calculation =2 (age + 4))
All doses to be checked with Alder Hey ABCD or B.N.F.
Try to prescribe eight hourly when possible to make it easier to fit in a school day.
Codeine phosphate
Pain relief dose
(Quick weight calculation =2 (age + 4))
Codeine syrup 25mg in 5ml, Tablets 15mg and 30mg.
(codeine linctus available for cough as 3mg in 5ml or 15mg in 5ml)
Stat dose 0.5mg (500microgrammes )/kg with a maximum 30mg at 12 years
Repeat dose after 4 hours upto 6 times a day.
Total maximum 3mg/kg/day upto 180mg /day at 12 years.
AGE |
APPROX WEIGHT |
DOSE of codeine phosphate syrup 25mg in 5ml |
NOT RECOMMENDED UNDER 1 YEAR OLD |
||
1 YEAR |
10kg |
5mg (1ml) |
3 YEARS |
15 kg |
7.5mg (1.5ml) |
5 YEARS |
20 kg |
10mg (2ml) |
10 YEARS |
30 kg |
15mg (3ml) |
12 YEARS |
40 kg |
20mg (4ml) |
15 YEARS |
50 kg |
30mg tablet |
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
Other paediatric drug doses:
Naloxone (Narcan)
Stat dose 10microgrammesg/kg over 5 minutes. A larger dose upto 100mcg/kg (max 2mg) may be given if response not adequate
Mannitol 20% (2g in 10ml)
0.5(2.5ml) to 1g (5ml)/kg IV Infusion
Hydrocortisone
4mg/kg then 2 to 4mg/kg every 6 hours
(Slow IV)
Paraldehyde
0.3ml/kg (Rectal)
(In glass syringe mixed in 50% Olive Oil
A plastic syringe can be used if administered immediately)
Aminophylline
Loading Dose 5mg/kg over 10mins
Then 1mg/kg/hr as IV Infusion
Diazepam
400 mcg/kg slow IV
Then 100 to 400 mcg/kg/hr
Infusion.
Under 1yr to 2.5mg Rectal
1 to 3 yrs to 5mg Rectal
4 to 12 yrs to 5 to 10mg Rectal
Diazemuls
Stat Dose by Slow IV
200 microgrammes/kg,larger doses my be needed to control convulsions
Phenobarbitone
15mg/kg by Slow IV no more than 1mg/kg/minute. Must be diluted.
See guides for further information.
Phenytoin
15mg/kg loading dose by slow IV at no more than 1mg/kg/minute. Monitor ECG and BP.
See guides for further information.
Double check all doses before administration
Doses contained in this guide are for quick reference only and should be used together with full prescribing information.
DISCLAIMER – It is the individual’s responsibility to double-check all doses in this guideline and ensure they are correct.
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