Manual of pediatric Emergency medicine

Respiratory system:
Drug Doses:

Salbutamol: 0.03 ml/kg/dose for nebulization

Adrenaline:0.1-0.5 ml/kg of 1:10000 for nebulization

(To make 1:10000 take 1 ml of 1:1000 Adrenaline and mix with 9 ml of NS)

Hydrocortisone:5mg/kg IV Stat

Ipratropium:0.5-1 ml for nebulization

Neonatal Emergency:
Neonatal Seizure
Neonatal Hypoglycemia:
Drug Doses:
10% dextrose:2-4ml/kg iv stat
Phenobarbitone:20 mg/kg diluted in 20
ml Ns given over 20 min as loading
dose.For maintainence dose 5-7 mg/kg
in two divided dose
Phenytoin: 20 mg/kg diluted in 20 ml Ns
given over 20 min as loading dose.For
maintainence dose 5-7 mg/kg in two
divided dose
Midazolam:0.1-0.2 mg/kg iv
Lorazepam:0.1 mg/kg iv
Cardiovascular:
Heart failure:
Tachypnea
Tachycardia
Liver enlargement
Basal crepts
Heart murmur
Cardiomegaly
Record BP and if within normal range give
Inj Lasix 1-2 mg/kg iv stat and keep Lasix
BD/TD as per need.
Keep baby NPO start Iv fluid that should be
2/3rd of maintenance .
Put baby on propped up position
Oxygen inhalation via hoodbox
Give antibiotics if infection is precipating
factor
Digitalize if needed
Do ECG and chest xray
Supraventricular tachycardia:

Inj Adenosine 0.1 mg/kg via rapid flush

method.If initial dose donot revert double
the dose till max 12 mg is reached.
Drug doses:
Lasix:1-2 mg/kg iv
Adenosine:0.1 mg/kg iv
Digoxin : Oral

For iv digitalization use 75% of oral dose

Gastroenterology:

Acute gastroenteritis with severe

dehydration:
Drug doses:
Iv fluid calculation:
For maintenance

For deficit:weight* % of dehydration

Zinc:10 mg for 14 days for age <6 months
and 20 mg for 14 days for age>6 months
Probiotic:Enterogermina(1 tube Bd)/Bifilac
5 ml po bd
Ranitidine:1 mg/kg iv bd
Buscopan:10-20 mg iv /po
Nervous system:
1) Febrile convulsion:Keep child on left lateral
positionMaintain ABC---Measure GRBS(If low
GRBS give 2ml/kg of 10% dextrose iv stat)---Give
inj midazolam ,side by side blood investigations
should be drawn.Fever should be controlled by
cold sponging and antipyretics.

2) Status Epilepticus:
Drug dose:
10% dextrose:2-4ml/kg iv stat
Phenobarbitone:20 mg/kg diluted in 20
ml Ns given over 20 min as loading
dose.For maintainence dose 5-7 mg/kg
in two divided dose
Phenytoin: 20 mg/kg diluted in 20 ml Ns
given over 20 min as loading dose.For
maintainence dose 5-7 mg/kg in two
divided dose
Midazolam:0.1-0.2 mg/kg iv
Lorazepam:0.1 mg/kg iv
Diazepam:0.3 mg/kg iv or 0.5 mg PR
Sryup Flexon:wt/2
Drop Niko:wt/10
 Skin:

Acute urticarial:
1) Inj Avil 0.5mg/kg iv stat
2) Inj hydrocortisone 5-10mg/kg iv
stat
3) Calamine lotion LA Tds
Drug doses:
1) Antibiotics
Cefotaxim:50 mg /kg/dose iv tds.For
meningitis 200 mg/kg iv in 3-4 divided
doses.

Ceftriaxone:50-75 mg /kg iv in 2 divided

doses.For meningitis 100 mg/kg iv in 2
divided dose(Ceftriaxone should be
diluted in 50 ml ns given slowly over 45
min)

Clavam:40-100 mg/kg iv in 3 divided

doses(For oral clavam 228.5mg/5ml
wt/2 in two divided dose)

Ampicillin:100-400 mg/kg iv in 3
divided doses

Ceftazidime:50 mg/kg/dose iv Tds

Gentamycin:5 mg/kg iv od

Amikacin:7.5 mg/kg/dose iv bd

Vancomycin:15-20 mg/kg/dose iv
tds/qid(Each dose diluted in 20-40 ml
given over one hr)

Meropenam: 15-20 mg/kg/dose iv

tds/qid

Clindamycin:10 mg/kg/dose iv tds

Metronidazole: 10 mg/kg/dose iv
tds(for oral syrup metron
200mg/5ml0.25 ml/kg/dose tds)

Azithromycin:100mg/kgwt/2 po od if
100mg/5ml---wt/4 po od
Cefixime:50mg/5mlwt/2 po bd ..if
100mg/5ml---wt/4 po bd

Cepfodoxime: 50mg/5mlwt/2 po
bd ..if 100mg/5ml---wt/4 po bd

Norfloxacin125mg/5ml---0.5 ml/kg
po in two divided doses

Flucloxacillin-50-100 mg/kg iv in 4
divided doses(syrup flucloxacillin
125mg/5ml---0.5ml/kg in 4 divided
dose)

Antipyretic:
Flexon:10-15 mg/kg/dose po
tds/qid(syrup flexon wt/2 po tds/qid)
For drop niko wt/10 po tds/qid
 Dose for Ace suppository 10-15
mg/kg/dose

Antiepileptic:
Phenobarbitone:20 mg/kg diluted in 20 ml
Ns given over 20 min as loading dose.For
maintainence dose 5-7 mg/kg in two
divided dose

Phenytoin: 20 mg/kg diluted in 20 ml Ns

given over 20 min as loading dose.For
maintainence dose 5-7 mg/kg in two
divided dose

Midazolam:0.1-0.2 mg/kg iv
Lorazepam:0.1 mg/kg iv
Diazepam:0.3 mg/kg iv or 0.5 mg/kg PR
Cough syrup:
Dry cough: syrup TUSQ-DX wt/3/dose po
tds

Productive cough: TUSQ-X wt/3/dose po

tds

Syrup salbutamol: wt/3/dose po tds

For diarrhea:ORS

Zinc:10 mg for 14 days for age <6 months

and 20 mg for 14 days for age>6 months
Probiotic:Enterogermina(1 tube Bd)/Bifilac
5 ml po bd
Antihelmintic:
Albendazole:200 mg for <2 yrs and 400 mg
for >2 years po stat(syrup albendazole
200mg/5ml5ml for <2 yrs and 10 ml
for >2 years po stat)

For sedation:
Inj phergan 0.5mg/kg/dose iv stat plus Inj
midazolam 0.2 mg/kg iv stat

For constipation:syrup lactulose 5-15 ml

po bd/tds

Nebulization:
Salbutamol: 0.03 ml/kg/dose for nebulization
Adrenaline:0.1-0.5 ml/kg of 1:10000 for nebulization
(To make 1:10000 take 1 ml of 1:1000 Adrenaline and mix with 9 ml
of NS)
Ipratropium:0.5-1 ml for nebulization

For nebulization above calculated dose diluted in 2-3 ml ns

Anti-histamine
Syrup cetirizine 5mg/5ml2.5-10 ml
po hs

Syrup fexofenadine 30mg/5ml---5-10

ml po bd