2nd Edition and Most Updated Version. Pediatrics medications doses and its emergency related cases were always problematic for new junior doctors. I hope with this new update, I tried to make it much simpler and much easier to be accessed quickly in emergencies to reach its maximum benefits. Any comment or recommendation is welcomed. Thank you. Dr. Essam Sidqi April 2022 * Edits on below medications: Ketotifen Syrup 1mg/5ml 0.025mg/kg/dose x2 0.125cc/kg/dose x2 Ventolin (Butadin) Syrup 2mg/5ml >2 years  0.1-0.4mg/kg/dose x3 0.25-0.8cc/kg/dose x3 Vitamin D3 Oral Drops 10,000IU/ml Prophylaxis:400IU/day (10mcg)1drop x1 Voltaren Suppository 12.5mg, 25mg, 50mg, 100mg 1-2mg/kg/dose x2 or x3 Oframax 500mg/Claforan 500mg Vial [Avoid R.L.] 25-50mg/kg/day ÷2 (Or weight in kg/day ÷2 in cc (10cc dilution)) Ampicillin 500mg / Amoxicillin 500mg Vial 50-100mg/kg/day ÷2 (Or weight in kg/day ÷2 in cc (5cc dilution)) (Max. 500mg/dose) Zofran (De-vomit) Amp 2mg/ml 0.15mg/kg/dose x3 2cc + 3cc D.W.  1cc/10kg x3 (Max. 5cc) (Max. 8mg/dose) Parol Bottle 1gm/100ml (Max. 60mg/kg/day) Voltaren Amp. IM 75mg/2ml <12 years1-2mg/kg/dose >12 years x1 or x2 Lasix Amp. 20mg/2ml 0.5-1mg/kg/dose x2 or x3 Tagamet (Cimetidine) Amp. 200mg/2ml 5-10mg/kg/dose x4 Magnesium Sulphate MgSO4 Vial 50% 5g/10ml 10% 1g/10ml 25-50mg/kg/dose x3 IM or Infusion (Max. 2g/hr) Potassium Chloride KCl Amp. 15%= 2mEq/ml = 2mmol/ml = 150mg/ml 7.5%= 1mEq/ml = 1mmol/ml = 75mg/ml 0.5-1mEq/kg/dose (Max. 40mEq/dose) Infusion (Max. 10mEq/hr) Albumin Bottle 20% 20g/100ml, 10g/50ml 20% = 200mg/ml 0.5-1g/kg/dose x1 x2 or x3 2.5-5cc/kg/dose x1 x2 or x3 Over 30min-2hr infusion Sodium Bicarbonate NaHCO3 Vial 8.4% 50mEq/50ml 8.4% = 1mEq/ml = 84mg/ml 1mEq/kg/dose in 15-30min infusion 1cc/kg/dose in 15-30min

1. P E D I A T R I C S
EMERGENCY & MEDICATIONS DOSES
2nd
Edition
BY:
DR. ESSAM S. YAQOOB
DUHOK - KURDISTAN REGION - IRAQ
APRIL 2022

2. 1 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
Amoxil Syrup
30-50mg/kg/day ÷3
125mg/5ml → 1-2cc/kg/day ÷3
200mg/5ml → 0.75-1.25cc/kg/day ÷3
250mg/5ml → 0.5-1cc/kg/day ÷3
400mg/5ml → 0.35-0.65cc/kg/day ÷3
Augmentin Syrup
30-50mg/kg/day ÷3
← (125/31.25mg)/5ml
← (200mg/28.5mg)/5ml
← (250mg/62.5mg)/5ml
← (400mg/57mg)/5ml
Acyclovir Syrup 200mg/5ml
<12 years → 20mg/kg/dose x4
0.5cc/kg/dose x4
>12 years → 800mg/dose x5
20cc/dose x5
(5 days)
Suprax (Cefixime) Syrup
8mg/kg/day x1
100mg/5ml → 2cc/5kg x1 or ÷2
200mg/5ml → 1cc/5kg x1 or ÷2
Erythromycin Syrup
30-50mg/kg/day ÷3
125mg/5ml →1-2cc/kg/day ÷3
200mg/5ml →0.75-1.25cc/kg/day ÷3
250mg/5ml →0.5-1cc/kg/day ÷3
400mg/5ml →0.35-0.65cc/kg/day ÷3
Flagyl (Metronidazole) Syrup
30mg/kg/day ÷3
125mg/5ml →1cc/kg/day ÷3
200mg/5ml →0.75cc/kg/day ÷3
250mg/5ml →0.6cc/kg/day ÷3
Trimethoprim Syrup
(40mg/200mg)/5ml
>2 months → 8-12mg/kg/day ÷2
1cc/kg/day ÷2
Clarithromycin Syrup
>6 months → 15mg/kg/day ÷2
125mg/5ml → 0.6cc/kg/day ÷2
250mg/5ml → 0.3cc/kg/day ÷2
Nystatin Oral Drops
<1 year → 2cc x4
>1 year → 4-6cc x4
Azithromycin Syrup
10mg/kg/day x1
100mg/5ml → 0.5cc/kg/dose x1
200mg/5ml → 0.25cc/kg/dose x1
Nalidixic Acid Syrup
250mg/5ml, 300mg/5ml
55mg/kg/day ÷4
1cc/kg/day ÷4
Albendazole Syrup
100mg/5ml, 200mg/5ml
<2 years → 200mg once
>2 years → 400mg once
Keflex (Cephalexin) Syrup
25-50mg/kg/day ÷3 or ÷4
125mg/5ml → 1-2cc/kg/day ÷3 or ÷4
250mg/5ml → 0.5-1cc/kg/day ÷3 or ÷4
Cefdinir Syrup
>6months → 7mg/kg/dose x2
125mg/5ml → 0.3cc/kg/dose x2
250mg/5ml → 0.15cc/kg/dose x2
Mebendazole Syrup
>2 years
100mg/5ml → 100mg/dose x2
(3 days)
500mg/5ml → 500mg/dose once.
Pediatric Syrup Doses
* All Doses are Age and Condition and Severity Dependent.

3. 2 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
Parol Syrup
10-15mg/kg/dose x3 or x4
120mg/5ml→ 0.5cc/kg/dose x3 or x4
250mg/5ml→ 0.2-0.3cc/kg/dose x 3 or x4
Adol Oral Drops 100mg/ml
2-3 drops/kg/dose x3 or x4
ParAzar Flu Syrup (Colden)
(125mg/1mg)/5ml
1-2 years→ 2.5-5cc x3
1-6 years→ 5-10cc x3
6-12 years→ 10-15cc x3
Profen Syrup 100mg/5ml
>6 months → 5-10mg/kg/dose x3
0.5cc/kg/dose x3 (Max. 40mg/kg/day)
Depakin Syrup 200mg/ml
B:10-15mg/kg/day ÷1 ÷2 ÷3
M: 30-60mg/kg/day ÷1 ÷2 ÷3
Ketotifen Syrup 1mg/5ml
0.025mg/kg/dose x2
0.25cc/10kg/dose x2
Fenistil (Dimethindene) Oral
Drops
3 drops/kg/day ÷3
Loratadine Syrup 5mg/5ml
>2-6 years→ 5cc/day x1 at night
>6 years→ 10cc/day x1 at night
Allermine (Chlorpheniramine) Syrup
2mg/5ml
0.35mg/kg/day ÷3 or ÷4
0.85cc/kg/day ÷3 or ÷4
Diphenhydramine Syrup
12.5mg/5ml
5mg/kg/day ÷3 or ÷4
0.5cc/kg/day ÷3 or ÷4
Desloratadine Syrup 0.5mg/ml
1-6 years→ 2.5cc/day x1 at night
6-12 years→ 5cc/day x1 at night
>12 years→ 10cc/day x1 at night
Actifed Syrup (30mg/1.25mg)/5ml
>2 years → 4mg/kg/day ÷3 or ÷4
0.7cc/kg/day ÷3 or ÷4
Dexon Syrup 0.5mg/5ml
0.15-0.3mg/kg/day ÷3
1-3cc/kg/day ÷3
(Max. 16mg/day) (5 days)
Prednisolone Syrup (5 days)
1-2mg/kg/day ÷2
5mg/5ml → 1-2cc/kg/day ÷2
15mg/5ml → 0.35-0.7cc/kg/day ÷2
Exidil (Bronquium) Syrup
2-6 years→ 5cc x2 or x3
6-12 years→ 10cc x2 or x3
>12 years→ 15cc x2 or x3
Solvodin Syrup 4mg/5ml
2-6 years→ 2.5cc x3
6-12 years→ 5cc x3
>12 years→ 10cc x3
DryCough Syrup 15mg/5ml
4-6 years → 2.5cc x3
6-12 years → 5cc x3
>12 years → 10cc x3
Samillin Syrup
1-5 years → 2.5cc x3
6-12 years → 5cc x3
>12 years → 10cc x3
Tussilet Syrup
<1 year → 2.5cc x3
1-6 years → 5cc x3
6-12 years → 10cc x3
Ventolin (Butadin) Syrup
2mg/5ml
>2 years → 0.1mg/kg/dose x3
0.25cc/kg/dose x3

4. 3 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
De-vomit (Zofran) Syrup 4mg/5ml
2mg/10kg/dose x3
2cc/10kg/dose x3
Motilium (Domperidone) Syrup 5mg/5ml
0.2-0.4mg/kg/dose x3
1-2cc/5kg/dose
Biolact Sachet
6 months-2 years x1
>2 years x2
Bonnisan Syrup
<1 month→ 2.5cc x3
1-6months→ 5cc x3
6 months-3 years→ 10cc x3
Colic EZ (Simethicone) Oral Drops
<6 months→ 0.5cc x4
6 months-1 year→ 0.75cc x4
>1 year→ 1cc x4
Zinc Syrup 20mg/5ml
(14 days)
<1 year→ 10mg (2.5cc) x1
>1 year→ 20mg (5cc) x1
Buscopan (Spasmodain) Syrup
5mg/5ml
<6 months → 1-4cc x3
6 months-6 years→ 5cc x3
6-12 years→ 10cc x3
Ferrous Fumerate Syrup 140mg/5ml
1-2mg/kg/day ÷3 Prophylaxis
3-4mg/kg/day ÷3 Mild →0.15cc/kg/day ÷3
4-6mg/kg/day ÷3 Severe IDA
Periactin Syrup 2mg/5ml
2-6 years → 5cc x2 or x3
>6 years → 10cc x2 or x3
Multivitamins Oral Drops
<1 year → 0.3cc (6 drops) x1
1-5 years→ 0.6cc (12 drops) x1
>5 years → 1cc (20 drops) x1
Vitamin D3 Oral Drops 10,000IU/ml
Prophylaxis: 400IU/day (10mcg) x1
Treatment: <6 months → 3,000IU/day x1
(6 drops)
>6 months → 6,000IU/day x1 (12 drops)
Vitamin B6 (Pyridoxine)
Syrup 20mg/5ml
Convulsion: 50-100mg PNG
Deficiency: 2.5-10mg/day
NaCl Nasal Drops x4 or x6 Lactulose Syrup 667mg/ml
0.5cc/kg/dose x2 or x3
B.T. Enema 65ml Once.
Voltaren Suppository
12.5mg, 25mg, 50mg, 100mg
1mg/kg x2 or x3
Paracetamol Suppository
125 mg, 250 mg
15mg/kg x2 or x3
Bisacodyl Suppository 10mg
<6 years→ 5mg x1
>6 years→ 10mg x1
Oral Rehydration Solution ORS
Add 1 Sachet to 1 L of water for 24hr and give as following (or more if child wants more accordingly):
Mild dehydration: 10cc/kg after each diarrheal stool.
Moderate dehydration: 20cc/kg/hr. (Reassess after 4hrs accordingly).
Severe dehydration: 20cc/kg/hr. PO/PNG with IV Fluids. (Hospital admission).

5. 4 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
Oframax 1gm / Claforan 1gm
Vial [Avoid R.L.] (Max. 4g/day)
50-100mg/kg/day ÷2
(Or weight in kg/day ÷2 in cc
(Neonates) (10cc dilution))
Clindamycin Amp.
300mg/2ml, 600mg/4ml
20-40mg/kg/day ÷3 or ÷4
Ampicillin 500mg / Amoxicillin 500mg Vial
50-100mg/kg/day ÷2
(Or weight in kg/day ÷2 in cc (Neonates)
(5cc dilution))
(Max. 500mg/dose)
Meropenem Vial 250mg, 500mg,
1g
20-40mg/kg/dose x3
Imipenem/Cilastatin Vial
250mg/250mg, 500mg/500mg
20-40mg/kg/dose x3
Vancomycin Vial 250mg, 500mg, 1g
15-20mg/kg/dose in 1hr x3 or x4
Gentamicin Amp.
20mg, 40mg, 60mg, 80mg
5-7mg/kg/day ÷2
Amikacin Vial 250mg,
500mg
15mg/kg/day ÷2
Flagyl Bottle 500mg/100ml
30mg/kg/day ÷3
2cc/kg/dose x3
Penicillin G Procaine Vial IM
25.000-50.000 units/kg/day
Flucloxacillin Vial 500mg,1g
25-50mg/kg/dose x3 or x4
Acyclovir Vial 250mg, 500mg, 1gm
10-20mg/kg/dose x3 (5-10 days)
Zofran (De-vomit) Amp 4mg/2ml
0.1mg/kg/dose x3 (Max. 4mg)
2cc + 3cc N.S. → 1cc/10kg x3
(Max. 5cc)
Parol Bottle 1gm/100ml
10-15mg/kg/dose x3 or x4
1-1.5cc/kg/dose x3 or x4
(Max. 4g/day)
Aminophylline Amp. 250mg/10ml
(1cc+9cc N.S.)
Bolus: 4-5mg/kg → 2cc/kg
Maintenance: 3-6mg/kg → 1cc/kg/dose x3
Decadron Amp. 8mg/2ml
Croup: 0.6mg/kg/day once
Others: 0.2-0.6mg/kg/day ÷2
Voltaren Amp. IM 75mg/3ml
<12 years→2mg/kg/dose
>12 years→ x1 or x2
Cyklokapron Amp. 100mg/ml
10mg/kg/dose x3 infusion
Hydrocortisone Vial 100mg
1-5mg/kg/day ÷2 or ÷3
Allergic Reaction: 4-5mg/kg/dose
Diphenhydramine Amp.
10mg/ml, 50mg/ml
5mg/kg/day ÷4
Allarmine (Chlorpheniramine) Amp.
10mg/1ml
0.25mg/kg/dose
Omeprazole Vial 20mg or 40mg
1mg/kg/day x1 infusion
Buscopan Amp. 20mg/ml
0.3-0.5mg/kg/dose x3
Tagamet (Cimetidine) Amp. 200mg/2ml
25mg/kg/day ÷4
Morphine Amp. IM/SC 10mg/ml
0.05-0.2mg/kg/dose
Lasix Amp. 20mg/2ml
1mg/kg/dose
Hydralazine Amp. 20mg/ml
0.1-0.2mg/kg/dose. Can repeat after 20 min.
Pediatric IV/IM Doses

6. 5 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
Magnesium Sulphate MgSO4 Vial
50% 5g/10ml
10% 1g/10ml
25-50mg/kg/dose x3
IM or Infusion
Potassium Chloride KCl Amp.
15%= 2mEq/ml = 2mmol/ml = 150mg/ml
7.5%= 1mEq/ml = 1mmol/ml = 75mg/ml
0.5-1mEq/kg/dose
Over 3-4 hrs (Max. 40mEq/dose)
Calcium Gluconate 10%
1gm/10ml Amp.
0.5-1cc/kg/dose in 30min x2
or x3
(Max. 20cc/dose)
Albumin Bottle 20%
20g/100ml, 10g/50ml
20% = 200mg/ml
0.5-1g/kg/dose x2 or x3
2.5-5cc/kg/dose x2 or x3
Over 1-2hr infusion
Mannitol Bottle
Bolus: 0.25-1g/kg
Maintenance: 0.25-0.5g/kg x2 or x3
20% = 200mg/ml
B:5cc/kg, M:2.5cc/kg x2 or x3 infusion
10% = 100mg/ml
B:10cc/kg, M:5cc/kg x2 or x3
Sodium Bicarbonate
NaHCO3 Vial 8.4%
50mEq/50ml
8.4% = 1mEq/ml = 84mg/ml
1mEq/kg/dose in 15-30min
infusion
1cc/kg/dose in 30min
Caffeine Amp. 10mg/ml, 20mg/ml
Bolus: 10-20mg/kg
Maintenance: 5-10mg/kg/day
Vitamin B6 (Pyridoxine) Amp.
100mg/2ml, 100mg/ml
Convulsion: 70mg/kg over 10 min.
Deficiency: 10-20mg/day for 3 weeks
Vitamin K Amp. 1mg/0.5ml
Prophylaxis IM: term 1mg
or preterm 0.5mg
Treatment SC: 1mg
Hypertonic G.W. D10% = 100mg/ml
<5 year
Bolus: 0.25-0.5g/kg → 2-5cc/kg
2cc G.W50%+ 8cc D.W = G.W.10%
1cc GW50%+9cc GW5% ≈GW10%
Maintenance: 5-8mg/kg/min.
Hypertonic G.W. D25% = 250mg/ml
<12 years
0.25-0.5g/kg → 1-2cc/kg
5cc G.W50% + 5cc D.W = G.W.10%
4cc GW50% + 6cc GW5% ≈ GW10%
Hypertonic G.W. 25g/50ml
D50% = 500mg/ml
>12 years
0.25-0.5g/kg → 0.5-1cc/kg
(Diluted)
Whole Blood 500ml/pint
10-15cc/kg/over 3-4hr (NEED ABO,
Rh Compatibility)
PRBC 350ml/pint
10–15cc/kg/over 3-4hr (NEED ABO, Rh
Compatibility)
FFP 200-300ml/pint
10-15cc/kg in 20min (JUST
ABO Compatibility)
Platelets 200-300ml/pint
5-10cc/kg in 20min (NEED ABO,
Better Rh Compatibility too)
Cryoprecipitate 10-20ml/pint
1-2pints/10kg (Preferred ABO
Compatibility)
* All Doses are Age and Condition and Severity Dependent.

7. 6 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
Adrenaline Amp. 1mg/1ml (1:1000)
<30kg→0.1mg/kg/dose
>30kg → 0.3-0.5mg/kg/dose
1cc + 9cc N.S. → 0.1cc/kg/dose
Repeat if needed after 3-10min
Atropine Amp. 0.6mg/1ml
0.03mg/kg/dose
1cc + 4cc N.S. → 0.2cc/kg/dose
Propranolol Amp. 1mg/ml
0.1mg/kg/dose in 15 min
Noradrenaline Amp.
0.05-0.1mcg/kg/min.
(Max. 1-2mcg/kg/min)
4cc + 46cc D5% =
4mg/4ml → 0.04-0.08cc/kg/hr.
(Max. 0.08-0.15cc/kg/hr.)
8mg/4ml → 0.02-0.06cc/kg/hr.
(Max. 0.04-0.07cc/kg/hr.)
Dopamine Amp.
200mg/5ml, 400mg/10ml
1-5mcg/kg/min.
Then 5-20mcg/kg/min.
(Max. 50mcg/kg/min.)
5cc + 45 D5% →
0.15-0.08cc/kg/hr.
Then 0.08-0.3cc/kg/hr.
(Max.0.75cc/kg/hr.)
Dobutamine Amp. 250mg/20ml
0.5mcg-1mcg/kg/min.
Then 2-20mcg/kg/min.
(Max. 40mcg/kg/min.)
20cc + 30cc D5% →
0.006-0.012cc/kg/hr.
Then 0.024-0.24cc/kg/hr.
(Max. 0.5cc/kg/hr.)
Amiodarone Amp. 150mg/3ml
Cardiac Arrest: 5mg/kg (Max. 300mg)
3cc + 12cc D5% → 0.5cc/kg.
May repeat up to 2 times.
Fentanyl Amp. 50mcg/ml
Bolus: 0.5-2mcg/kg
Maintenance: 0.5-2mcg/kg/hr.
2cc + 10cc N.S. →0.1cc/kg
Propofol Amp. 1% 10mg/ml
Bolus: 2.5-3.5mg/kg
Maintenance: 0.125-0.3mg/kg/min
0.1cc/kg (Pure)
Adenosine Amp. 6mg/2ml, 12mg/4ml
0.1mg/kg
(2cc + 4cc N.S.) → 0.1cc/kg/dose
2 syringes: 1st
for adenosine, 2nd
for
>5cc N.S. → To be pushed together at
same time in 3 sec. rapid flush.
Repeat if needed after 1-2 min.
Isoptin Amp 5mg/2ml, 10mg/4ml
>1 year → 0.1-0.3mg/kg in 2 min.
(Max. 5mg)
2cc + 3cc N.S. →
0.1-0.3cc/kg/dose in 2 min. (Max.
5cc)
Repeat if needed after 30 min.
Lidocaine Amp.
1% = 10mg/ml
2% = 20mg/ml
VT/VF/Local Anesthesia
Bolus: 0.5-1mg/kg
(Max. 4.5mg/kg)
Maintenance: 1.2-3mg/kg/hr.
Ventolin (Salbutamol) Neb. 5mg/2.5ml
>2 years→ 0.1mg/kg x4
(Max. 2.5mg/dose) (2-4cc N.S. dilution)
Pulmicort Neb. 0.25mg/ml
>1 year→ 1-2cc x2
(2-4cc N.S. dilution)
Adrenaline amp Neb. 1mg/ml
0.5-1cc/dose
(2-4cc N.S. dilution)

8. 7 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
IV Fluids Therapy Maintenance for Neonates:
First 2 days is G.W. D10% then change to G.S. (5%-1/5)
If on Phototherapy: add 30cc/kg/24hr. (IV Fluid)
If on Feeding: 10-15cc/kg/day every 2-3hrs (i.e. ÷12 or ÷8)
then Subtract this amount from the total maintenance.
Mature or >1kg Premature or <1kg
1st
day:60-70cc/kg/24hr
2nd
day: 80cc/kg/24hr
3rd
day: 100cc/kg/24hr
4th
day: 120cc/kg/24hr
5th
day: 140cc/kg/24hr
Others: 150cc/kg/24hr
1st
day: 80cc/kg/24hr
2nd
day: 95cc/kg/24hr
3rd
day: 110cc/kg/24hr
4th
day: 125cc/kg/24hr
5th
day: 140cc/kg/24hr
Others: 150cc/kg/24hr
Bolus (Shoot) → N.S. or R.L. 20cc/kg in
20min-1hr up to 3 times
Maintenance for Older Children: G.S.
<10kg (1st
10kg) 100cc/kg/24hr
10-20kg (2nd
10kg) (1000cc + 50cc/kg for
every Kg >10)/24hr
>20kg (3rd
10kg) (1500cc + 20cc/kg for
every Kg >20)/24hr
Deficit for Older Children: G.S.
Mild dehydration 30-50cc/kg
Moderate dehydration 60-100cc/kg
Severe dehydration 90-150cc/kg
• Inform The Police for a Police Paper for cases of Poisoning, Inhalation and Ingestion of
Foreign Body or Animal or Ticks Bites and Scorpion Sting or Any Abuse or Suspicious case.
• Any case Death on Arrival, inform the police and refer to Forensics.
• Any new case being referred or admitted to the floor (wards) from the emergency department
that needs follow-up medications and vitally, like DKA or convulsion etc, the JHOs in ER
should inform the JHO on call in the floors (wards).
23hr Fluid for Older Children = Maintenance + Deficit – Bolus
½ amount in first 8hr.
½ amount in other 15hr.

9. 8 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
Sliding Scale for Sub-Cutaneous Soluble Insulin Injection in Diabetic Patients:
Pediatric DKA Management:
1. ABC and Double Cannula
2. Foley’s catheter
3. Bolus of N.S. 20cc/kg in 1hr then in the 2nd
hr start the below:
a) Fluid Per Hour for 23hr Equation:
[ (Maintenance + Deficit 85cc/kg) – Bolus ] all divided by 23hr
If RBS >250mg/dl then use N.S.
If RBS <250mg/dl then use G.S.
b) Soluble Insulin Infusion Per Hour: 0.1 unit/kg/hr.
Calculate the dose for 6hrs, dilute it with 30cc N.S., to be infused in 6hrs with Syringe Pump.
c) Antibiotics and Analgesics: Oframax Vial and Parol Bottle etc.
d) KCl Amp.: 1cc/kg/24hr infusion in the fluid or 1cc for each 100cc of the fluid. (1cc=2mEq).
RBS Every 6hr Amount of S.C. Soluble Insulin (Actrapid, Humulin R)
0-150 mg/dl Nothing
150-200 mg/dl 0.1 unit/kg
200-300 mg/dl 0.2 unit/kg
300-400 mg/dl 0.3 unit/kg
400-500 mg/dl 0.4 unit/kg
>500 mg/dl 0.5 unit/kg

10. 9 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
Neonatal Convulsion
IV cannula
Vital signs
including
RBS, if
hypoglycemic
treat with
G.W. D10%
→2cc/kg.
Luminal (Phenobarbital)
Amp. 200mg/ml
Bolus: 15-20mg/kg
1cc + 9cc N.S. →1cc/kg in
20 min.
If no response give 2nd
dose.
If response put on
maintenace after 12hr.
Maintenance:
3-5mg/kg/day ÷2
1cc + 9cc N.S.
→20 units/kg/day ÷2 in
20min.
If no response:
Phenytoin Amp.
250mg/5ml
(50mg/ml)
Bolus:15-20mg/kg
5cc + 10cc N.S.
→1cc/kg in 20
min.
Maintenance:
4-8mg/kg/day ÷2
5cc + 10cc N.S.
→50 units/kg/day
÷2 in 30min only
by N.S.
If no response: *
Midazolam Amp.
15mg/3ml (5mg/ml)
Bolus: 0.05-0.4mg/kg
1cc + 4cc N.S. →
0.1-0.2cc/kg in 3 min.
Maintenance:
0.03-0.2mg/kg/hr
• Calculated as [(0.1mg
× Kg × 24)mg
changed to cc of the
corresponding
original amp. cc + X
cc G.W.] = 24cc then
1cc/hr infusion.
Diazepam Amp. 10mg/2ml
IV: 0.2-0.5mg/kg
2cc + 3cc N.S. → 1cc/10kg
PR: 0.2-0.5mg/kg or 0.25cc/kg
Use NG tube or Foley’s
catheter or small syringe.
(Up to 3 doses)
If no response:
Luminal
(Phenobarbital)
Amp. 200mg/ml
Dosing as above.
If no response:
Phenytoin Amp.
250mg/5ml
(50mg/ml)
Dosing as above.
If no response: *
Midazolam
Amp. 15mg/3ml
(5mg/ml)
Dosing as above.
Older Children Convulsion
* If still no response in the last step, then consider Calcium Gluconate IV and Magnesium Sulphate IV and Pyridoxine PNG (neonate) or IV/IM.

11. 10 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
References:
➢ https://www.medscape.com/
➢ https://www.medicines.org.uk/emc/
➢ https://www.uptodate.com/
➢ https://bestpractice.bmj.com/
➢ https://www.drugs.com/
➢ https://www.rxlist.com/
➢ https://globalrph.com/
➢ https://www.webmd.com/
➢ BNF 81