Emergency Drug

Inj.Dopamine :(200mg/5ml)

Dose:

• Renal dose: 5 μg/kg/min
• cardiac dose:10-15 μg/kg/minute (syringe pump)

Example : baby weight - 5 kg 

Calculation: wt X dose X 24 hours X minutes in hours (10μg/kg/min)

= 5 X 10 X 24 X 60 

= 72000  μg ( its 24 hours requirement ) 

• Now its converts μg to mg = 72000  ÷  1000 = 72 mg 
• Now its converts mg to ml : (72 X 5 )  ÷ 200 = 1.8 ml {inj.Dopamine(200mg/5ml)}

( 1.8 ml dopamine for 24 hours , so we mixed 22.2 ml Normal saline )

Order : ( 1.8 ml dopamin + 22.2 ml normal saline )=24 ml 

• I/V @ 1ml /hours (throgh Syringe pump)

Inj.Midazolam (15mg/3ml):

Example: baby weight -10kg 

Loading/stat dose: 0.15 mg/kg 

= ( 0.15 mg  X 10 kg X  3 ml )  ÷15mg

= 0.3 ml 

Order: inj.midazolam(15mg/3ml) 

0.3ml I/V stat 

Maintainance dose: 1-3 μg /kg/min 

• maintainance dose for 10 kg: 1μg /kg/min 

Calculation: dose X  weight X 24hours X 60 mintues in hours

= 1 X 10 X  24 X 60

=14400 μg

• Now its converts μg to mg = 14400 ÷1000 = 14.4
• Now its converts mg to ml = (14.4  X 3)  ÷ 15 = 2.8 ml 

( 2.8  ml midazolam for 24 hours , so we mixed 21.2  ml Normal saline )

Order : ( 2.8 ml midazolam + 21.2 ml normal saline )=24 ml 

• I/V @ 1ml /hours (throgh Syringe pump)

Short cut: average

Example wt-5 kg

inj.Midazolam (15mg/3ml ) + 47 ml normal saline = 50 ml /15mg  ( 1ml = 0.3mg)

then , calculation :  wt  X 2  X 0.1 
= 5  X 2 X 0.1 

= 1 ml  ( 1 

Order: 1 ml / hours throgh syringe pump 

(this dose equivent 1 μg/kg/min, if need 2 μg then double the dose)

Inj.Adrenaline (1mg/1ml)

Stat/Loading dose:

0.1 μg/kg 

Preparation: ( 1ml + 9 ml distilled water)= 10 ml 

Order: 0.1 ml / kg stat 

Maintainance dose: 

Dose: 0.1 - 0.3 μg/kg/min 

Example : wt - 3kg 

calculation: wt X dose X 24 h X 60 min 

= 0.1 X 3 X 24 X 60  ( 0.1 μg/kg/min )

= 432 μg

Then its converts μg to mg = 432 ÷ 1000 = 0.4 mg 

then its converts mg to ml = 1 X  0.4 = 0.4 ml { bcz inj.Adrenaline (1ml/1mg)}

Mixeture: 0.4ml + 23.6 ml normal saline = 24 ml 

Order: 

1 ml/hours I/V (by syringe pump)

NaHCo3: 

Dosage based on base deficit:

HCO3 needed (mEq)  =  HCO3 deficit (mEq/L)  x  (0.3 x body wt [kg])

• Administer half of calculated dose, then assess need for remainder [1].

Resuscitation (routine use not recommended): 

Usual dosage: 1 to 2 mEq/kg IV/IO slowly [2].

Example:

Patient Weight-10kg ,ABG HC03 level - 17 (normal 22-32 mmol/l)

Incase metabolic acidosis: 

HCO3 needed (mEq)  =  HCO3 deficit (mEq/L)  x  (0.3 x body wt [kg])

= 17 x  0.3 x  10 

= 51 mEq 

we give 25.5 mEq (half calculated) I/V slowly 

Resuscitation  dose :  In.Sodib (7.5mg/100ml)

=10kg x 1 ml + same amount Distilled water 

=10 + 10 =20 ml 

Order: 20ml  I/V slowly 

Indication:

Metabolic acidosis: Treatment of normal anion gap metabolic acidosis caused by renal or

gastrointestinal losses.

Cardiac resuscitation: Sodium bicarbonate is not a recommended therapy in neonatal

resuscitation guidelines [5][2]. After effective ventilation is established in patients with

documented metabolic acidosis, sodium bicarbonate may be used [2].

Note:

Intravenous: Administer slow IV push. Rapid IV administration (10 mL/min) of hypertonic

sodium bicarbonate may lead to serious consequences (hypernatremia, a decrease in CSF

fluid pressure, and possible intracranial hemorrhage) in neonates and children younger than

2 years. MAX 8 mEq/kg/day[3]. The preferred concentration for slow IV administration in

neonates is the 4.2% strength (0.5 mEq/mL) [3][2]. Other recommended pediatric

concentrations for infusions are 0.25 mEq/mL and 1 mEq/mL [4].

Do not administer by the endotracheal route [2].

Magnesium sulfate:

inf.Nalepsin(4gm/100ml)

Resuscitation : 

25 to 50 mg/kg IV/intraosseous rapid infusion (over several minutes).

Hypomagnesemia:

25 to 50 mg/kg IV infusion over 30 to 60 minutes; repeat dose as necessary . For

hypomagnesemia/torsades with pulses, an infusion time of 10 to 20 minutes is recommended

Daily Maintenance Requirements (Parenteral Nutrition)

0.25 to 0.5 mEq/kg/day IV .....3 days.

Inj.Dobutamine (12.5/ml)

Dose:

•  dose:10-15 μg/kg/minute (syringe pump)
  

Example : baby weight - 5 kg 

Calculation: wt X dose X 24 hours X minutes in hours (10μg/kg/min)

= 5 X 10 X 24 X 60 

= 72000  μg ( its 24 hours requirement ) 

• Now its converts μg to mg = 72000  ÷  1000 = 72 mg 
• Now its converts mg to ml : (72 X 1 )  ÷ 12.5 = 5.7 ml {inj.Dobutamin(12.5mg/ml)}

( 5.7 ml dobutamine for 24 hours , so we mixed 18.3 ml Normal saline )

Order : ( 5.7 ml dobutamine + 18.3 ml normal saline )=24 ml 

• I/V @ 1ml /hours (throgh Syringe pump)