Pediatric Advanced Life Support (PALS) Medications (per 2015 PALS) – IWK Drug Information Resource

Pediatric Dosing/Administration Calculator Tools

Pediatric Advanced Life Support (PALS) / Anaphylaxis / Status Epilepticus Calculator

Date Monday, June 5, 2023

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Pediatric Advanced Life Support (PALS) Medications (modified from 2015 PALS)

Dose calculations below are based on Intravenous/Intraosseous route unless otherwise specified.

Adenosine, First dose (0.1 mg/kg)
Dose
Concentration	3 mg/mL
Volume
Notes/Admin Instructions	Maximum: 6 mg/dose. IV over 1 second, flush with at least 5 mL of sodium chloride 0.9%. Give at IV site closest to heart. Only give IO if no IV access.

Adenosine, Repeat Dose (0.2 mg/kg)
Dose
Concentration	3 mg/mL
Volume
Notes/Admin Instructions	Maximum: 12 mg/dose. IV over 1 second, flush with at least 5 mL sodium chloride 0.9%. Give at IV site closest to heart. Only give IO if no IV access.

Amiodarone Pulseless VF/VT (5 mg/kg)
Dose
Concentration	50 mg/mL
Volume
Notes/Admin Instructions	Maximum: 300 mg/dose. For cardiac arrest, IV over 1–2 seconds. May repeat up to 3 times.

Amiodarone, SVT/VT with Pulse (5 mg/kg)
Dose
Concentration	6 mg/mL
Volume	( of 50 mg/mL + D5W)
Notes/Admin Instructions	Supplied as 50 mg/mL. Must be diluted to 6 mg/mL. Maximum: 300 mg/dose. IV over 20–60 minutes.

Atropine (0.02 mg/kg) using 0.1 mg/mL syringe
Dose
Concentration	0.1 mg/mL
Volume
Notes/Admin Instructions	Maximum: 0.5 mg/dose. IV over 1 minute.

Atropine (0.02 mg/kg) using 0.2 mg/mL syringe
Dose
Concentration	0.2 mg/mL
Volume
Notes/Admin Instructions	Maximum: 0.5 mg/dose. IV over 1 minute.

Calcium Chloride (20 mg/kg)
Dose
Concentration	100 mg/mL
Volume
Notes/Admin Instructions	Maximum: 1000 mg/dose. IV over 10–20 seconds. May repeat as needed.

EPINEPHrine IV/IO (0.01 mg/kg)
Dose
Concentration	0.1 mg/mL
Volume
Notes/Admin Instructions	Maximum 1 mg/dose. IV over 1–2 seconds. May repeat every 3 to 5 min.

Dextrose (D50W) (0.5 g–1 g/kg)
Dose
Concentration	0.5 g/mL
Volume
Notes/Admin Instructions	Maximum: 25 g/dose. IV (central line preferred) over 2–3 minutes.

Magnesium Sulfate Pulseless VT (25–50 mg/kg)
Dose
Concentration	200 mg/mL
Volume
Notes/Admin Instructions	Maximum: 2000 mg/dose. IV over seconds.

Naloxone (0.1 mg/kg)
Dose
Concentration	0.4 mg/mL
Volume
Notes/Admin Instructions	Maximum: 2 mg/dose. 0.1 mg/kg/dose IV over seconds, may repeat doses q2mins to effect.

Sodium Bicarbonate (1 mmol/kg)
Dose
Concentration	1 mmol/mL
Volume
Notes/Admin Instructions	Maximum: 100 mmol/dose. IV over 2 minutes.

Anaphylaxis Medications

EPINEPHrine IM (0.01 mg/kg)
Dose
Concentration	1 mg/mL
Volume
Notes/Admin Instructions	Maximum: 0.5 mg/dose. Intramuscular.

Status Epilepticus

Midazolam IV/IO, IM (0.1 mg/kg)
Dose
Concentration	1 mg/mL
Volume
Notes/Admin Instructions	Maximum: 4 mg/dose. IV over 30 seconds.

Midazolam buccal, intranasal (0.1 mg/kg)
Dose
Concentration	5 mg/mL
Volume
Notes/Admin Instructions	Maximum: 10 mg/dose. Intranasal must be given with atomizer.

Lorazepam IV, IO (0.1 mg/kg)
Dose
Concentration	1 mg/mL
Volume	( of 4 mg/mL + of D5W)
Notes/Admin Instructions	Supplied as 4 mg/mL. Must be diluted to 1 mg/mL. Maximum: 4 mg/dose. IV over 30 seconds.

Phenytoin (20 mg/kg)
Dose
Concentration	10 mg/mL
Volume	( of 50 mg/mL + of NaCI 0.9%)
Notes/Admin Instructions	Supplied as 50 mg/mL. Must be diluted to 10 mg/mL and infused with 0.22 micron in–line filter. Maximum: 1000 mg/dose. IV over 20 minutes.