| SBP | mmHg (– mmHg)* |
| HR | – bpm† |
| RR | – bpm† |
| Endotracheal tube (ETT) | |
|---|---|
| Laryngoscope | |
| Uncuffed ETT | |
| Cuffed ETT | |
| Depth at lips | cm |
| Supraglottic airway device (SAD) | |
|---|---|
| LMA | |
| i-Gel | |
| Breathing circuits | |
|---|---|
| T-piece | 0–20 kg |
| Infant (Micro) circle | 0–10 kg |
| Paediatric (Mini) circle | 10–30 kg |
| Adult circle | >20 kg |
| Ventilation | |
|---|---|
| Tidal volume (6-8 ml/kg) | |
| Neonates/ARDS (4-6 ml/kg) | |
| Induction | ||
|---|---|---|
| Fentanyl | 1–2 mcg/kg | mcg |
| Ketamine | 1–2 mg/kg | mg |
| Rocuronium | 1 mg/kg | mg |
| Maintenance infusions | ||
|---|---|---|
| Morphine | 10–40 mcg/kg/h (0.5–2 ml/h) | |
| Midazolam | 1–3 mcg/kg/min (1–3 ml/h) | |
| Propofol |
1–4 mg/kg/h (4–10 mg/kg/h in routine anaesthesia) |
|
| Emergency Drugs | ||
|---|---|---|
| Atropine | 20 mcg/kg | mcg |
| Adrenaline IV 1:10,000 | 0.1 mL/kg | mL |
| Suxamethonium IV | 1–2 mg/kg | mg |
| Suxamethonium IM |
4 mg/kg (Max 150 mg) |
mg |
| Other | ||
|---|---|---|
| Fluid bolus | 10–20 mL/kg | mL |
| Glucose 10% | 2 mL/kg | mL |
| Defibrillation energy | 4 J/kg | J |
For other drugs and infusions, use Paediatric Emergency Tools: Apple / Android.
| Midazolam - PO | 0.5 mg/kg | mg |
| Max 20 mg per dose; 6 months - 14 years. Peak effect at 20-30 mins. | ||
| Midazolam - NAS | 0.2 mg/kg | mg |
| Max 10 mg. Given via short atomiser: 0.1 ml dead space. Peak effect at 10 mins. | ||
| Dexmedetomidine - NAS | 2–4 mcg/kg | mcg |
| Max 200 mcg per dose. Given 30 mins before intervention. | ||
| Induction | ||
|---|---|---|
| Fentanyl | 1–2 mcg/kg | mcg |
| Propofol | 3–5 mg/kg | mg |
| Rocuronium | 0.6 mg/kg | mg |
| Antiemetics | ||
|---|---|---|
| Dexamethasone | 0.15 mg/kg | mg |
| Ondansetron | 0.15 mg/kg | mg |
| Cyclizine | 0.5–1 mg/kg | mg |
| Intraoperative analgesia | ||
|---|---|---|
| Paracetamol IV | mg | |
| Ibuprofen IV | mg | |
| Ketorolac | 0.5–1 mg/kg | mg |
| Morphine | 0.05–0.1 mg/kg | mg |
| Reversal of neuromuscular blockade | ||
|---|---|---|
|
Neostigmine & Glycopyrulate |
0.02 mL/kg | ml |
| Sugammadex | 2 mg/kg | mg |
|
Moderate block: Return of T2 in response to TOF. |
||
| Sugammadex | 4 mg/kg | mg |
|
Deep block: 1-2 PTCs, no twitch responses to TOF. |
||
| Postoperative analgesia | ||
|---|---|---|
| Paracetamol PO | mg | |
| Ibuprofen PO | 5–10 mg/kg | mg |
| Morphine PO | mg | |
| Emergency Drugs | ||
|---|---|---|
| Atropine | 20 mcg/kg | mcg |
| Suxamethonium IV | 1–2 mg/kg | mg |
| Suxamethonium IM |
4 mg/kg (Max 150 mg) |
mg |
| Amoxicillin | 30 mg/kg (Max 1 g) | mg |
| Cefuroxime | 50 mg/kg (Max 1.5g) | mg |
| Co-Amoxiclav | 30 mg/kg (Max 1.2 g) | mg |
| Flucloxacillin (Soft tissue) | 25 mg/kg (Max 1 g) | mg |
| Flucloxacillin (Open orthopaedic surgery) | 50 mg/kg (Max 2 g) | mg |
| Metronidazole | 30 mg/kg (Max 500 mg) | mg |
| Teicoplanin | mg | |
| Gentamicin | 2.5 mg/kg (Max 160 mg) | mg |
| In obesity, doses should be calculated based on adjusted body weight. | ||
| Gentamicin (high-dose) | 5 mg/kg (Max 480 mg) | mg |
| In obesity, doses should be calculated based on adjusted body weight. | ||
| Arterial lines - Radial | |
|---|---|
| Neonates/Infants <10 kg |
24 G Pressure transducer: 150 mmHg (generates a flow rate of 1.5 mL/hr) |
| Children >10 kg |
22 G Pressure transducer: 300 mmHg (generates a flow rate of 3 mL/hr) |
| Children >50 kg | 20 G |
| Arterial lines - Femoral | |
|---|---|
| Neonates | 22 G, 8cm |
| Children | 20 G, 8cm |
| Central venous access - Femoral (preferred) | |
|---|---|
| <6 months | 4–5 Fr, triple lumen, 6–8cm lines |
| 6 m–5 y | 5 Fr triple lumen, 8–12 cm |
| >5 y | 7 fr, triple lumen, 15 cm |
| Central venous access - Internal jugular | |
|---|---|
| <15 kg | 5 cm |
| 16–40 kg | 8 cm |
| >40 kg | 13 cm |
| EZ-IO | |
|---|---|
| <--- | --- |
| --- | --- |
| >--- | --- |
| Suction catheters | |
|---|---|
| <--- | --- |
| --- | --- |
| >--- | --- |
Other calculators
Paeds Prescribing Pro Drug Calculator
Paediatric Emergency Tools: Apple / Android
Retrieval Teams
South Thames Retrieval Service (STRS) Clinical Guidelines
Children’s Acute Transport Service (CATS) Clinical Guidelines
Southampton Oxford Retrieval Team (SORT) Clinical Guidelines
Specific Emergency Guidelines
STRS Intubation Guideline and Checklist
Airway Guidelines
DAS Difficult intubation during routine induction of anaesthesia in a child aged 1–8 years guideline
DAS Cannot Intubate and Cannot Ventilate (CICV) in a paralysed anaesthetised child aged 1–8 years
Anaphylaxis Guidelines
APLS Perioperative Anaphylaxis algorithm
APLS Refractory Anaphylaxis algorithm
Advanced Paediatric Life Support (APLS) 2021 Resources
Neonatal Life Support Algorithm
APLS Paediatric Cardiac Arrhythmias Algorithm
APLS Paediatric Emergency Algorithms and Resources
Paediatric Advanced Life Support Guidelines (Resuscitation Council UK)
| Weight (kg) | |
|---|---|
| Age 1-12 months |
0.5 x Age (months) + 4 |
| Age 1-5 years |
2 x Age (years) + 8 |
| Age 6-14 years |
2 x Age (years) + 8 3 x Age (years) + 7 |
| Airway and Ventilation | |
|---|---|
| ETT size |
Uncuffed ETT size = (Age/4) + 4 [Cole formula] Cuffed ETT size = (Age/4) + 3.5 [Modified Cole] |
| ETT depth (oral) |
Above 1 year: Depth ≈ Age/2+12 Neonates: Depth ≈ 1.17 × Birth weight (kg) + 5.58 (Tochen / “7-8-9” rule) |
| ETT depth (nasal) |
Above 1 year: Depth ≈ Age/2+15 |
| Circulation | |
|---|---|
| Lowest acceptable SBP |
<1 month: ≥60 mmHg 1 month to 1 year: ≥70 mmHg 1–10 years: 2 x Age + 70 mmHg |
| Lowest acceptable MAP |
Age (in years) x 1.5 + 40 mmHg |
| Premature Neonates |
Gestational age ≈ Mean Arterial Pressure |