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1

Adrenaline Indications

Cardiac ArrestAnaphylaxis or severe allergic reactionSeere life-threatening bronchospasm OR silent chest (only able to speak in single works AND/OR silent chest AND/OR haemodynamic compromise AND/OR an ALOC)Bradycardia with poor perfusion (unresponsive to atropine AND/OR TCP)Croup (with stridor at rest)Shock unresponsive to adequate fluid resuscitation (excluding haemorhagic cause)

2

Adrenaline DosagesAnaphylaxis OR severe allergic reaction

IM - ACP1, ACP2, CCP≥ 6 years - 300 microgrepeat at 5 minute intervals. No max dose< 6 years - 150 microgRepeat at 5 minute intervals. No max dose.IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 minute intervals. No max dose.NEB - ACP2, CCP5mg Single dose only

3

Adrenaline DosagesSevere life-threatening bronchospasm OR silent chest

IM - ACP1, ACP2, CCP≥ 6 years - 300 microgrepeat at 5 minute intervals. No max dose< 6 years - 150 microgRepeat at 5 minute intervals. No max dose.IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 minute intervals. No max dose.

4

Adrenaline DosagesCardiac Arrest

IV - ACP2, CCP≥ 10kg (≥ 1 year) - 10microg/kgRepeat at 3-5 minute intervals. No max dose.<10kg (<1 year) - 100 microgRepeat at 3-5 minute intervals. No max dose.

5

Adrenaline DosagesCroup

NEB - ACP2, CCP5mg. Single Dose only.

6

Adrenaline DosagesShock Unresponsive to adequate fluid resus

IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 min intervals. No max dose.

7

Adrenaline DosagesBradycardia with poor perfusion

CONSULT!

8

Amiodarone Paediatric Indications

Cardiac arrest (refractory VF or pulse-less VT)

9

Amiodarone DosagesCardiac Arrest

IV/IO5mg/kgSlow push over 2 minutesSingle dose only

10

Atropine Indications

Bradycardia (with poor perfusion)Envenomation (with increased parasympathetic activity)Hypersalivation (secondary to ketamine administration)Organophosphate toxicity (with cardiac AND/OR respiratory compromise)

11

Atropine DosagesBradycardia

IV/IO - CCP20 microg/kg (Single dose not to exceed 600 microg) Repeat ONCE at 2 minutes.Total max dose 40 microg/kg

12

Atropine DosagesEnvenomation and Organophosphate toxicity

IM/IV/IO - ECP, CCP (IO CCP only)20 microg/kg (Single dose not to exceed 600 microg)Repeat at 5 minute intervals. No Max dose.

13

Atropine DosagesHypersalivation

IV - CCP20 microg/kg (single dose not to exceed 600 microg)Single dose only

14

Calcium Gluconate Paediatric Indications

Suspected Hyperkalaemic cardiac arrestSevere HyperkalaemiaCalcium Gluconate Blocker toxicityHypotension associated with Magnesium infusion (that fails to respond to IV fluid therapy)

15

Calcium Gluconate DosagesAll indications

IV/IO - CCP0.5 mL/kg (or 50 mg/kg)Slow push over 2-5 minutes.Repeated once at 10 minutes.

16

Ceftriaxone Indications

Suspected meningococal septicaemia (with a non-blanching petechial and/or purpuric rash)

17

Ceftriaxone Dosages

IM - ACP1, ACP2, CCP50 mg/kg (rounded up to the nearest 5kg)Reconstitute in 3.6mL water for ingection.IV/IO - ACP2, CCP (IO CCP ONLY)50 mg/kg (rounded up to the nearest 5kg)Reconstitute in 9.6mL water for ingection.

18

Fentanyl Indications

Significant PainSedation (for maintenance of established ETT)

19

Fentanyl DosagesSignificant Pain

NAS - ACP2, CCP≥ 1 year (CCP 6 months) - 1.5 microg/kgRepeat at 1 microg/kg at 10 minutes.< 1 year (CCP 6 months) - CONSULTIM - ACP2, CCP≥ 1 year - 1-2 microg/kg (CCP 2 microg)Single max dose 50 microgTotal max dose 2 microg/kg< 1 year - CONSULTIV - ACP2, CCP≥ 1 year - 1microg/kgSingle max dose 25 microgRepeat at 0.5 microg/kg (max 25 microg) at 5 minutes.Total max dose 2 microg/kg. (CCP - no max dose)< 1 year - CONSULT

20

Fentanyl DosagesSedation

IV/IO - CCP≥ 1 year - 1 microg/kgSingle max dose 25 microgConsider administration with midazolam. No max dose.<1 year - Consult

21

Glucagon Indications

Symptomatic hypoglycaemia (with inability to self-administer oral glucose)

22

Glucagon Dosages

> 25 kg - 1 mg single dose only.≤ 25 kg - 0.5 mg single dose only.

23

Glucose 10% Indications

Symptomatic hypoglycaemia (with inability to self-administer oral glucose)

24

Glucose 10% Dosages

IV/IO - ACP2, CCP (IO CCP only)0.25 g/kg (2.5mL/kg)Repeat at 1mL/kg boluses every 5 minutes until BGL < 4.0 mmol/L

25

Glucose gel Indications

Symptomatic hypoglycaemia (with ability to self-administer oral glucose)

26

Glucose Gel Dosages

PO - ACP1, ACP2, CCP≥ 2 years - 15gRepeat once at 15 minutes if BGL <4 mmol/LTotal max dose 30g

27

Glyceryl Trinitrate Paediatric Indications

Autonomic Dysreflexia (SBP > 160 mmHg)Irukandji Syndrome (SBP > 160 mmHg)

28

GTN DosagesAll inidcations

Sublingual - ACP2, CCPCONSULT

29

Hydrocortisone Indications

Moderate or Severe AsthmaSevere allergic reaction OR anaphylaxis (requiring adrenaline (epinepherine) administration)Symptomatic adrenal insufficiency

30

Hydrocortisone DosagesModerate or Severe AsthmaSevere allergic reaction OR anaphylaxis

IM/IV - ECP (with consult), CCP5mg/kg Single dose only. Not to exceed 100mg)IV single dose only

31

Ipratropium Bromide Indications

Moderate OR severe bronchospasm

32

Ipratropium Bromide Dosages

NEB - ACP1, ACP2, CCP≥ 2 years - 250 microg. Single dose

33

Ketamine Paediatric Indications

- Severe traumatic pain (following 0.2mg-0.2mg/kg morphne or 1-2 microg/kg fentanyl) associated with: - fracture reduction and splinting - multiple or significant fractures requiring facilitated extrication - Patients with splinted fractures requirign ongoing narcortic analgesia for transport requirements)Induction of anasethesia- Severe traumatic pain associated with burns- Ongoing traumatic pain unresponsive to narcotics (following 0.2-0.3 mg/kg morphine OR 2-3 microg/kg fentanyl)

34

Ketamine DosagesSevere traumatic pain associated with burns

IV - CCPCONSULT

35

Ketamine DosagesOngoing traumatic painSevere traumatic pain

IV - CCP> 1 year - 100microg/kg (0.1mg/kg)Repeate every 2-3 minutesTotal max dose 1mg/kg

36

Ketamine DosagesInduction of anaesthesia

IV/IO - ECCP0.25-2mg/kgSingle dose onlyTotal max dose 100mg

37

Magnesium Sulphate Indications

Irukandji SyndromeSever Life-threatening asthmaTorsades de PointesBox jellyfish envenomation

38

Magnesium Sulphate DosagesIrukandji syndrome and Box jellyfish envenomation

IV - E.ACP2, CCP0.1 mmol/kg over 15 minutes (rounded p to nearest 0.5 mmol). Single max dose 5 mmolRepeat once at 10 minutesTotal max 10 mmol.

39

Magnesium Sulphate DosagesTorsades de Pointes

IV/IO - CCP0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol)Single dose not to exceed 5 mmolRepeat once at 10 minutesTotal max dose 10 mmol

40

Magnesium Sulphate DosagesSevere life-threatening asthma

IV/IO - CCP0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol)Single dose not to exceed 5 mmol

41

Midazolam Indications

Generalized seizures/focal seizures (GCS < 12)SedationAcuute behavioural disturbance (with SAT score at 2 or >)

42

Midazolam DosagesGeneralized Seizures/focal seizures

NAS - ACP2, CCP200 microg/kgSingle dose not to exceed 5mg.Repeat at half the initial dose at 10 minutes (max 0.25mg)Total Max 10mgIM - ACP2, CCP200 microg/kgSingle dose not to exceed 5mg.Repeat at half the initial dose at 10 minutes (max 0.25mg)Total Max 10mgIV/IO - CCP100mcg/kgSingle dose not to exceed 2.5mgRepeat at 5 min intervalsTotal max dose 10mg

43

Midazolam DosagesSedation

IV/IO - CCPUp to 100 microg/kgSingle dose not to exceed 2.5mgRepeat at 3-5 minute intervalsTotal max dose 5mg

44

Midazolam DosagesAcute Behavioural disurbance

IM (only if IV access not acheiveable)≥ 8 years - 200 microg/kgSingle dose only. Max 5mgIV - CCP≥ 8 years - 100 microg/kgSingle dose only. Max 2.5mg

45

Naloxone Indications

Respiratory depression (secondary to administration of narcotic drugs)

46

Naloxone Dosages

IM - ACP2, CCP20 microg/kgSingle dose only. Not toe xceed 800 microg.

47

Ondansetron Indications

Nausea AND/Or vomiting

48

Ondansetron Dosages

IM - ACP1≥ 5 years - 2mgSingle dose onlyIM - ACP2, CCP≥ 3 years - 100 microg/kgsingle dose only, not to exceed 4mgIV - ACP2, CCP≥ 3 years - 100 microg/kgsingle dose only, not to exceed 4mgSlow push over 2-3 minutes

49

Paracetamol Indications

Minor painFever (causing distress)

50

Paracetamol Dosages

PO - ACP1, ACP2, CCP≥ 1 month - 15mg/kgSingle dose only

51

Promethazine Paediatric Indications

Symptomatic rash/moderate allergic reactions

52

Promethazine Dosages

IV - ECP (CONSULT), CCP≥ 2 years - 250 microg/kgSingle dose only. Not to exceed 12.5mgSlow push over 1 minutes

53

Salbutamol Indications

BronchospamsSuspected hyperkalaemia (with QRS widening AND/OR dissociation)

54

Salbutamol DosagesBronchospasm

NEB - ACP1, ACP2, CCP≥ 2 years - 5mgRepeated PRNNo max doseIV - CCP≥ 2 years - 5microg/kgSingle dose not to exceed 250 microg.Repeat once at 10 mintues

55

Salbutamol DosagesSuspected hyperkalaemia

NEB - CCP5mg - Single dose only

56

Sodium Bicarbonate Paediatric Indications

Cardiac ArrestSuspected hyperkalaemiaSignificant injury with potential for crush injury

57

Sodium Bicarbonate DosagesAll indicatiosn

IV/IO - ECP, CCP (IO CCP only)1mL/kg - Single Dose onlyECP must Consult