Pediatric Dosage Calculation
Overview
Pediatric dose calculation differs from adult practice in one decisive way: there is no standard dose to fall back on and no familiar number to recognise as wrong. Everything is derived from the child's weight in kilograms, so an error in the weight, the conversion or the arithmetic passes straight through into the syringe. Because the resulting volumes are small, a tenfold error still looks like a plausible amount. The safeguards are procedural rather than intuitive: a measured weight, a calculated safe range, a second nurse on high-alert drugs, and a syringe rather than a cup.
Interpretation
Technique
The pediatric sequence, every time
- Weigh in kilogramsmeasured, not reported
- Calculate the doseordered mg/kg x weight
- Calculate the rangereference low and high x weight
- Compareinside means give, outside means call
- Draw up in a syringethen have it checked if high-alert
During — Monitoring
Patient Teaching
Clinical Pearl
Weigh, calculate, check the range, then draw it up in a syringe. In a child there is no dose small enough to be safe by accident.