Emergency Drug Card - Pediatric

Authors: Rob Bryant, MD, Amie Hatch, PharmD, BCPS, Jeremy Bair, PharmD
Updated: 9/11/2013

Emergency Drug Card - Pediatric


Drug Indication / Dose
Adenosine Pediatric tachycardia with a pulse and poor perfusion: 0.1 mg/kg IV rapid bolus (max 6 mg), second dose 0.2 mg/kg (max 12 mg)
Amiodarone Cardiac Arrest (pulseless): 5 mg/kg IV/IO (max 300 mg), repeat twice to a max of 15 mg/kg/day
Wide complex tachycardia (stable): 5 mg/kg IV over 20-60 minutes (max 300 mg), may repeat to a max of 15 mg/kg/day
Atropine Pediatric bradycardia with pulse and poor perfusion: 0.02 mg/kg (max dose 0.5 mg); May repeat once.
Calcium Chloride 10% 20 mg/kg IV/IO (0.2 ml/kg) (max dose 2 g)
For non-cardiac arrest, use calcium gluconate, push slowly
Dextrose 25% 0.5-1 g/kg (2-4 ml/kg) slow IV/IO push (for newborns, use dextrose 10% 5-10 ml/kg)
Epinephrine 1:10,000 Cardiac Arrest (pulseless): 0.01 mg/kg (0.1 ml/kg of 1:10,000 concentration) IV/IO every 3-5 min (max 1 mg)
Magnesium Sulfate Pulseless VT with torsades de pointes: 25-50 mg/kg (max 2 g) IV/IO
Torsades de pointes with a pulse: 25-50 mg/kg IV, push slowly
Asthma: 25-50 mg/kg IV over 10-20 minutes (max single dose 2 g)
Procainamide Pediatric tachycardia with a pulse and poor perfusion: 15 mg/kg IV/IO over 30-60 minutes
Infusion: 20-80 mcg/kg/min
Sodium Bicarbonate 1 mEq/kg slow IV/IO (Use 4.2% concentration if <5 kg)

Rapid Sequence Intubation

Drug Dose
Etomidate 0.3 mg/kg IV push over 30-60 sec; onset 10-20 sec
Lidoocaine 2% 1-2 mg/kg IV push over 1 min (20 mg = 1 mL)
Rocuronium 0.6-1.2 mg/kg IV push; onset 1-2 min
Succinylcholine Infants: 2 mg/kg IV push over 10-30 sec; onset 30-60 sec (Consider atropine)
Children: 1-1.5 mg/kg IV push over 10-30 sec (Consider atropine)
IM: 3-4 mg/kg (max 150 mg); onset 1-4 min
Vecuronium 0.1 mg/kg IV push; onset 2-3 min


Drug Dose
Haloperidol 0.025-0.05 mg/kg per dose IV/IM

Vasopressors & Inotropes

Drug Dose
Dobutamine 5-20 mcg/kg/min IV
Dopamine 5-20 mcg/kg/min IV
Epinephrine 0.05-1 mcg/kg/min IV
Norepinephrine 0.1-2 mcg/kg/min IV
Phenylephrine Bolus: 5-20 mcg/kg/dose IV every 10-15 min
Infusion: 0.1-0.5 mcg/kg/min IV
Vasopressin Limited Data


Drug Dose
Diazepam 0.2-0.5 mg/kg PR
Fosphenytoin 20 mg/kg IV over 20 minutes
Levetiracetam 20 mg/kg IV over 20 minutes
Lorazepam 0.1 mg/kg IV
Midazolam 0.2 mg/kg IN using the 5 mg/ml concentration
Phenobarbital 10-20 mg/kg IV (max dose 800 mg) IV over 20-60 min, (see pharmacist for dilution recommendations)


Drug Dose
Nitroglycerin 0.25-0.5 mcg/kg/min, increase by 0.5-1 mcg/kg/min q3-5 min (max 20 mcg/kg/min)
Nitroprusside 0.2-8 mcg/kg/min

Allergic Reactions

Drug Dose
Dexamethasone IV or oral: 0.6 mg/kg (max 12 mg) (may use IV solution PO)
Diphenhydramine IV: 1-1.25 mg/kg
Epinephrine IM: 0.01 mg/kg every 5-15 minutes as needed (1:1,000 concentration)
Continuous infusion: 0.1-1 mcg/kg/min IV
Famotidine IV: 0.25 mg/kg
Methylprednisolone IV: 1-2 mg/kg IV (max 125 mg)
Ranitidine Oral: 2 mg/kg PO (max 150 mg)
IV: 0.5-1 mg/kg IV (max 50 mg)

Sedation & Analgesia

Drug Dose
Fentanyl IV: 1 mcg/kg IV
Intranasal: 1-2 mcg/kg (max 100 mcg) using the 50 mcg/ml concentration (no more than 1 ml/nare)
Ketamine Procedural sedation: 0.5-2 mg/kg IV push over 1 min, may repeat with half dose every 5-10 min PRN
IM: 3-8 mg/kg IM
PO: 6-10 mg/kg (mix with cola, give 30 min. prior to procedure)
Lorazepam IV: 0.05-0.1 mg/kg IV
Midazolam IV: 0.1 mg/kg IV
Intranasal: 0.4 mg/kg (max 10 mg) using the 5 mg/ml concentration
Morphine IV: 0.1 mg/kg IV
Propofol Bolus (procedural sedation): 0.5-1 mg/kg IV push, may repeat with 0.5 mg/kg every 3-5 min PRN

Overdose & Unresponsive

Drug Dose
N-acetylcysteine 1st dose: 150 mg/kg IV over 1 hour
2nd dose: 50 mg/kg IV over 4 hour
3rd dose: 100 mg/kg IV over 16 hour
Dextrose Infants ≤ 6 months: 0.25-0.5 g/kg/dose slow IV push (1-2 ml/kg/dose of D25 or 2.5-5ml/kg/dose of D10)
Children > 6 months: 0.5-1 g/kg/dose slow IV push (2-4 ml/kg/dose of D25, 5-10 ml/kg/dose D10)
Flumazenil Benzodiazepine reversal: 0.01 mg/kg (up to 0.2 mg) IV over 15 seconds.
May repeat 0.01 mg/kg (up to 0.2 mg) every min to max cumulative dose of 0.05 mg/kg or 1 mg.
Fomepizole Loading dose: 15 mg/kg IV over 30 min
Morphine Total reversal required: 0.1 mg/kg IV/IO/IM/SC/IN every 2 min PRN (max 2 mg)
Infusion: 0.002-0.16 mg/kg/hr IV


Drug Dose
Alprostadil (prostaglandin E1) Patent ductus arteriosus: 0.05-0.1 mcg/kg/min;
once therapeutic response is achieved reduce rate to lowest effective dose.
Factor VIII Minor bleeding: 10-15 IU/kg IV push over 3-5 min
Moderate bleeding: 10-30 IU/kg IV push over 3-5 min
Life-threatening bleeding: 30-50 IU/kg IV push over 3-5 min
Unfractionated Heparin VTE: Bolus 75 U/kg given over 10 min, infusion 15-20 U/kg/hr
Ondansetron IV or oral: 0.15 mg/kg (max 4 mg)


Prepared by: Amie Hatch, PharmD, BCPS and Jeremy Bair, PharmD, BCPS. Updated AUG 2013.

This document presents an evidence-based approach that is appropriate for most patients. It should be adapted to meet the needs of individual patients and situations, and should not replace clinical judgment.