Paediatric Dose Reference

This page contains a series of formulas and references for paediatric vital signs, drug doses, and equipment sizing.

Millipaed app logo

With the exception of formulas, the source data for these tables is the source data for the Millipaed app — what you see here is exactly what the app uses. This makes it easy to spot any errors in the underlying values, as well as doubling as a standalone reference. Consequently, the tables are auto-generated and a bit rough around the edges — apologies for the formatting.

References may vary with the values (particularly maximum doses) they list, understandably, as they are a product of the context they were developed for. I have endeavored to provide sensible defaults, but this does not replace the clinical judgement of the provider caring for the patient in front of them.

Formulas

Formulas are used to calculate some values, these include:

For completeness, here is the Dart code of the formulas:

// ETT cuffed size (mm): age_years / 4 + 3.5, rounded down to nearest 0.5
double _ettCuffedSize(double ageMonths) {
  final raw = ageMonths / 12 / 4 + 3.5;
  return (raw * 2).floorToDouble() / 2;
}

// ETT ID x 2 - 2
double _ettSuctionSize(double ageMonths) {
  final ettSize = ageMonths / 12 / 4 + 3.5;
  final raw = ettSize * 2 - 2;
  return (raw * 2).floorToDouble() / 2;
}

// Age/2 + 12
double _ettDepthOral(double ageMonths) {
  final raw = ageMonths / 12 / 2 + 12;
  return raw.ceilToDouble();
}

// Age/2 + 15
double _ettDepthNasal(double ageMonths) {
  final raw = ageMonths / 12 / 2 + 15;
  return raw.ceilToDouble();
}

// ETT ID x 2
double _idcSize(double ageMonths) {
  final ettSize = ageMonths / 12 / 4 + 3.5;
  final raw = ettSize * 2;
  return raw.floorToDouble();
}

// ETT ID x 4
double _iccSize(double ageMonths) {
  final ettSize = ageMonths / 12 / 4 + 3.5;
  final raw = ettSize * 4;
  return raw.floorToDouble();
}
  • Cuffed ETT size (mm): \({Age \over 4} + 3.5\)
    Rounded down.
  • Airway suction catheter size (Fr): \(ETT \ Size \times 2 - 2\)
  • Oral ETT depth (cm): \({Age \over 2} + 12\)
    Rounded up.
  • Nasal ETT depth (cm): \({Age \over 2} + 15\)
    Rounded up.
  • IDC size (Fr): \(ETT \ Size \times 2\)
  • ICC size (Fr): \(ETT \ Size \times 4\)

Median Values by Age

This table lists median height and weight, by sex, for the Australian population.

Age (months) Label Weight (kg) Height (cm)
0 Neonate 3.0 50
1 1 month 4.5 55
2 2 months 5.5 58
3 3 months 6.0 61
6 6 months 7.0 67
9 9 months 9.0 72
12 1 10.0 75
18 18 months 12.0 82
24 2 13.0 86
36 3 14.5 95
48 4 17.0 102
60 5 18.5 109
72 6 21.0 116
84 7 23.0 122
96 8 25.0 128
108 9 28.5 133
120 10 33.0 138
132 11 37.0 144
144 12 40.0 150
156 13 45.0 157
168 14 50.0 163
180 15 55.0 167
192 16 60.0 170
204 17 65.0 172
216 18 65.0 173
240 >18 65.0 173

Vital Signs

Scalars

  • Tidal Volume: 4 - 6 mL/kg
  • Circulating Volume: 80 mL/kg

Ranges

Age (months) Age (label) SBP HR RR
0 - 3 Birth - 3 mo 60 - 95 120 - 170 25 - 60
3 - 6 3 mo - 6 mo 60 - 105 115 - 170 25 - 60
6 - 12 6 mo - 12 mo 75 - 105 110 - 170 20 - 55
12 - 24 12 mo - 2 yr 70 - 105 105 - 150 20 - 45
24 - 48 2 yr - 4 yr 70 - 105 95 - 150 20 - 40
48 - 72 4 yr - 6 yr 75 - 110 80 - 150 17 - 30
72 - 96 6 yr - 8 yr 80 - 115 75 - 140 16 - 30
96 - 120 8 yr - 10 yr 80 - 115 70 - 130 16 - 30
120 - 144 10 yr - 12 yr 85 - 120 60 - 130 15 - 25
144 - 168 12 yr - 14 yr 90 - 120 65 - 120 15 - 25
168 - 192 14 yr - 16 yr 90 - 125 60 - 115 14 - 25
192 - 204 16 yr - 17 yr 90 - 130 60 - 115 14 - 25
204 - 216 17 yr - 18 yr 90 - 135 60 - 115 14 - 25

Drug Dosing

Advanced Life Support

Item Standard Dilution Range Dose Max Dose
Adrenaline 100 mcg/mL All ages 10 mcg/kg 1000 mcg
DC Cardioversion All ages 4 J/kg 200 J
Lignocaine (1%) 10 mg/mL All ages 1 - 2 mg/kg
Amiodarone 15 mg/mL All ages 5 mg/kg 300 mg
Sodium Bicarbonate 8.4% All ages 1 mL/kg

Emergency

Item Standard Dilution Range Dose Max Dose
Adrenaline IM (Anaphylaxis) 1000 mcg/mL Birth - 2 yr 100 mcg
Adrenaline IM (Anaphylaxis) 1000 mcg/mL 2 yr - 4 yr 150 mcg
Adrenaline IM (Anaphylaxis) 1000 mcg/mL 4 yr - 7 yr 200 mcg
Adrenaline IM (Anaphylaxis) 1000 mcg/mL 7 yr - 11 yr 300 mcg
Adrenaline IM (Anaphylaxis) 1000 mcg/mL 11 yr - 13 yr 400 mcg
Adrenaline IM (Anaphylaxis) 1000 mcg/mL 13 yr - 18 yr 500 mcg
Hydrocortisone 50 mg/mL All ages 4 mg/kg 100 mg
Synchronized Cardioversion All ages 1 - 2 J/kg 200 J
Atropine 100 mcg/mL All ages 10 - 20 mcg/kg 600 mcg
Adenosine 3 mg/mL All ages 0.1 - 0.3 mg/kg 12 mg
Calcium Chloride 10% All ages 0.2 mL/kg
Tranexamic Acid 100 mg/mL All ages 15 mg/kg 1000 mg
Glucose 10% All ages 2 mL/kg
Magnesium Sulfate 0.2 mmol/mL All ages 0.2 mmol/kg 10 mmol
Salbutamol IV (Loading) 100 mcg/mL All ages 15 mcg/kg 300 mcg

Neuro

Item Standard Dilution Range Dose Max Dose
Midazolam 1 mg/mL All ages 0.15 - 0.5 mg/kg 10 mg
Levetiracetam 50 mg/mL All ages 60 mg/kg 4500 mg
Mannitol (20%) 0.2 g/mL All ages 0.25 - 1 g/kg
3% Saline All ages 1 - 3 mL/kg 150 mL

Local Anaesthetics

Item Standard Dilution Range Dose Max Dose
Lignocaine 1% 10 mg/mL All ages 3 mg/kg
Lignocaine + Adrenaline 1% 10 mg/mL All ages 7 mg/kg
Ropivacaine 0.2% 2 mg/mL All ages 3 mg/kg
Ropivacaine 1% 10 mg/mL All ages 3 mg/kg
Bupivacaine 0.25% 2.5 mg/mL All ages 2.5 mg/kg

Premedication

Item Standard Dilution Range Dose Max Dose
Midazolam (PO) 5 mg/mL All ages 0.5 mg/kg 20 mg
Clonidine (PO) 150 mcg/mL All ages 4 mcg/kg
Clonidine (IN) 150 mcg/mL All ages 2 mcg/kg
Ketamine (PO) 100 mg/mL All ages 5 - 10 mg/kg
Ketamine (IM) 100 mg/mL All ages 5 mg/kg

Induction

Item Standard Dilution Range Dose Max Dose
Propofol 10 mg/mL Birth - 12 yr 2 - 5 mg/kg
Propofol 10 mg/mL 12 yr - 18 yr 1 - 3 mg/kg
Ketamine 10 mg/mL All ages 1 - 2 mg/kg
Fentanyl 10 mcg/mL All ages 1 - 5 mcg/kg

Relaxants

Item Standard Dilution Range Dose Max Dose
Suxamethonium (IV) 50 mg/mL All ages 1 - 2 mg/kg 3 mg; 3 mg/kg
Suxamethonium (IM) 50 mg/mL All ages 3 - 4 mg/kg
Rocuronium 10 mg/mL All ages 0.9 - 1.2 mg/kg
Vecuronium 1 mg/mL All ages 0.1 mg/kg
Pancuronium 1 mg/mL All ages 0.06 - 0.1 mg/kg
Atracurium 10 mg/mL All ages 0.3 - 0.6 mg/kg
Cisatracurium 2 mg/mL All ages 0.15 - 0.2 mg/kg

Reversal

Item Standard Dilution Range Dose Max Dose
Sugammadex 100 mg/mL All ages 2 - 16 mg/kg
Naloxone 400 mcg/mL All ages 10 mcg/kg 400 mcg
Flumazenil 100 mcg/mL All ages 5 - 10 mcg/kg 2000 mcg
Neostigmine 2.5 mg/mL Birth - 12 yr 0.05 mg/kg 2.5 mg
Neostigmine 2.5 mg/mL 12 yr - 18 yr 0.05 - 0.075 mg/kg 5 mg
Glycopyrrolate 200 mcg/mL All ages 4 - 10 mcg/kg 400 mcg

Vasoactives

Item Standard Dilution Range Dose Max Dose
Adrenaline (Push) 10 mcg/mL All ages 1 - 2 mcg/kg 50 mcg
Metaraminol (Push) 500 mcg/mL All ages 10 mcg/kg 500 mcg
Metaraminol (Infusion) 500 mcg/mL All ages 0.05 - 0.5 mcg/kg
Noradrenaline 60 mcg/mL All ages 0.01 - 1 mcg/kg/min
Glyceryl Trinitrate 600 mcg/mL All ages 0.2 - 5 mcg/kg/min
Sodium Nitroprusside 500 mcg/mL All ages 0.25 - 6 mcg/kg/min
Milrinone 400 mcg/mL All ages 0.25 - 0.75 mcg/kg/min

Fluids

Item Standard Dilution Range Dose Max Dose
Crystalloid Bolus All ages 10 - 20 mL/kg
PRBC All ages 4 - 10 mL/kg
FFP All ages 10 - 15 mL/kg
Platelets All ages 10 mL/kg

Opioids

Item Standard Dilution Range Dose Max Dose
Fentanyl 10 mcg/mL All ages 1 - 3 mcg/kg
Alfentanil 500 mcg/mL All ages 20 - 50 mcg/kg
Remifentanil 100 mcg/mL All ages 0.1 - 1 mcg/kg/min
Morphine (IV) 1 mg/mL All ages 0.05 - 0.2 mg/kg
Oxycodone (IV) 1 mg/mL All ages 0.05 - 0.2 mg/kg

Analgesia

Item Standard Dilution Range Dose Max Dose
Paracetamol All ages 15 mg/kg 1000 mg
Parecoxib All ages 1 mg/kg 40 mg
Ibuprofen All ages 5 - 10 mg/kg 400 mg

Antiemetics

Item Standard Dilution Range Dose Max Dose
Ondansetron All ages 0.1 mg/kg 8 mg
Metoclopramide All ages 0.15 mg/kg 20 mg
Dexamethasone All ages 0.15 - 0.6 mg/kg 12 mg

Antimicrobials

Item Standard Dilution Range Dose Max Dose
Cefazolin 100 mg/mL All ages 50 mg/kg 2000 mg
Ceftriaxone 100 mg/mL All ages 50 mg/kg 2000 mg
Flucloxacillin 100 mg/mL All ages 50 mg/kg 2000 mg
Piperacillin-Tazobactam 225 mg/mL All ages 100 mg/kg 4500 mg
Gentamicin 10 mg/mL Birth - 1 mo 5 mg/kg
Gentamicin 10 mg/mL 1 mo - 10 yr 7.5 mg/kg 320 mg
Gentamicin 10 mg/mL 10 yr - 18 yr 7 mg/kg 700 mg

Equipment

Airway

Item Standard Dilution Range Dose Max Dose
Macintosh Birth - 1 mo 0
Macintosh 1 mo - 6 mo 0 - 1
Macintosh 6 mo - 12 mo 0 - 1
Macintosh 12 mo - 3 yr 1 - 2
Macintosh 3 yr - 5 yr 2
Macintosh 5 yr - 10 yr 2 - 3
Macintosh 10 yr - 16 yr 3
Macintosh 16 yr - 18 yr 3 - 4
Miller Birth - 1 mo 0 - 1
Miller 1 mo - 6 mo 1
Miller 6 mo - 12 mo 1 - 1.5
Miller 12 mo - 3 yr 1.5 - 2
Miller 3 yr - 5 yr 2
Miller 5 yr - 10 yr 2 - 3
Miller 10 yr - 16 yr 3
Miller 16 yr - 18 yr 3
ETT (Cuffed) 15 yr - 18 yr 7.5 - 8.5 mm
ETT Depth (Oral) Birth - 3 mo 8 cm
ETT Depth (Oral) 4 mo - 11 mo 10 cm
ETT Depth (Oral) 11 mo - 13 mo 12 cm
ETT Depth (Oral) 15 yr - 18 yr 21 - 23 cm
ETT Depth (Nasal) Birth - 3 mo 10 cm
ETT Depth (Nasal) 4 mo - 11 mo 13 cm
ETT Depth (Nasal) 11 mo - 13 mo 14 cm
LMA 0 - 5 kg 1
LMA 5 - 10 kg 1.5
LMA 10 - 20 kg 2
LMA 20 - 30 kg 2.5
LMA 30 - 50 kg 3
LMA 50 - 70 kg 4
LMA 70 - 140 kg 5
Nasogastric Birth - 4 mo 6 - 8 Fr
Nasogastric 4 mo - 2 yr 8 - 10 Fr
Nasogastric 2 yr - 4 yr 10 Fr
Nasogastric 4 yr - 8 yr 10 - 12 Fr
Nasogastric 8 yr - 18y 4mo 10 - 14 Fr

References

  1. Children’s Health Queensland Hospital and Health Service. Children’s Resuscitation Emergency Drug Dosage (CREDD). 3rd Edition. Queensland Government.
  2. Perth Children’s Hospital. Medication Monographs. Government of Western Australia Child and Adolescent Health Service.
    Used monographs include: Adrenaline, Atracurium, Glyceryl Trinitrate, Glycopyrronium, Metaraminol, Midazolam, Milrinone, Morphine, Neostigmine, Noradrenaline, Oxycodone, Paracetamol, Parecoxib, Sodium Nitroprusside, Sugammadex, Suxamethonium.
  3. Royal Children’s Hospital. Sedative Premedication Guidelines. Royal Children’s Hospital, Melbourne.
  4. Cooksley, D. The Cooksley Cards. 2021 edition.
    IYKYK.