Paediatric Critical Care Infusions

Listed below are some of the more common critical care drug infusions used in critically ill children in the EC setting. These infusion ‘recipes’ are taken from the Red Cross Hospital Paediatric Intensive Care Unit protocols.

All (except Atropine and salbutamol) are to be diluted up to 50mls and used in syringe driver pumps.

Junior or inexperienced doctors are advised to discuss with their senior doctor or appropriate PICU or referral hospital prior to commencing these infusions.

• Morphine : 
  • 1 mg/kg in 50 mls 5% dextrose : 1 ml/hr = 20 µ/kg/hr
  • Dose Range : 20 – 60 µ/kg/hr
  • Run at 1 – 3ml/hr      
• Midazolam : 
  • 3mg/kg in 50 mls 5% dextrose: 1 ml/hr = 1 µ/kg/min
  • Dose Range : 1 – 4 µ/kg/min
  • Run at 1 – 4ml/hr
• Adrenaline :    
  • 0.06 mg/kg in 50 ml 5% Dextrose : 1 ml/hr = 0.02 µ/kg/min
  • Dose Range : 0.02 – 0.1 µ/kg/min 
  • Run at =  1-5ml/hr
  • (can be run peripherally)       
  • {note can go upto 25ml/hr – but must be in discussion with PICU}
• Dopamine :   
  • 6 mg/kg in 50 mls 5% Dextrose: 1 ml/hr = 2 µ/kg/min
  • Dose Range : 5 – 15 µ/kg/min
  • Run at 2.5 – 7.5ml/hr
  • (can be run peripherally)
• Prostin :      
  • 60 µ/kg in 50 mls normal saline: 1 ml/hr = 20 nanogram/kg/min
  • Dose Range : 10 – 60 nanogram/kg/min
  • Run at 0.5 – 3ml/hr
• Salbutamol : 
  • Use neat solution 1mg / ml
  • 0.06 - 0.12 ml/kg/hr  =  1 -2 µ/kg/min
• Atropine :   
  • Take 20mls of neat atropine, check how many mg/ml
  • Calculate infusion rate to deliver 0.2 mg/kg/hr Atropine
  • Dose Range : titrate dose down according to bronchial secretions & pupillary size