Typical newborn basal glucose require-ment is 5-8 mg/kg/min. Rapidly Do not follow with a flush First dose may be given via ET while UVC inserted . 1mg/1ml) to add to diluent (ml) . In cardiac arrest, 0.5 to 1.0 mg (5 to 10 mL of 0.1 mg/mL solution) may be given. Calculate the dose in mg: 18 kg × 100 mg/kg/day = 1800 mg/day. Neonatal Dose Pediatric Dose Cefoperazone (Cefobid®, Cefazone®) 1g/vial I.V 25-100mg/kg /day divided every 12hr IV administration 1 g + 10 mL NS 1 mL has 100 mg Therefore if the dose is 100 mg/kg/day, use ½ mL/kg/dose The soln is stable for 24hr at room temp and 5days in refrigerator Cefotaxime (Claforan®, Cefotax®) Although most facilities have pharmacy calculate and deliver unit dose medications, and have There are two strengths of adrenaline (epinephrine) available. Croup Possible Adverse Reactions 1. Primary outcome was survival to hospital discharge. • 4.4 mg per kg maximum dose (lido) X 68.2 kg= 300mg maximum dose lidocaine Synonyms . Relative effects of dopamine at different doses are uncertain because of developmental differences in: endogenous noradrenaline stores. Target Oxygen Saturation Table Initial oxygen concentration for PPV 1 min 60%-65% 2 min 65%-70% 3 min 70%-75% 4 min 75%-80% 5 min 80%-85% 10 min 85%-95% ≥ 35 weeks' GA 21% oxygen Variations of this dose ranging from 0.2 to 0.5 mg were recommended for the treatment of anaphylaxis as late as 1978. Neonates may be given a dose of 0.01 mg per kg of body weight; for the infant 0.05 mg is an adequate initial dose and this may be repeated at 20 to 30 minute intervals in the management of asthma attacks. Step 1. —- ///—- Calculate Max to get half the maxilla with one carp? Given via nebulization over 15 minutes prn Chief Indications 1. For infants requiring fluid restriction consider: VERY HIGH CONCENTRATION IV infusion* Infusion dose Prescribed amount 1 mL/hour = 0.4 microgram/kg/minute 1200 microgram/kg adrenaline and make up to 50 mL Draw up 1200 microgram/kg [12 mL/kg] of 1:10,000 adrenaline and add glucose 5% ONLY to make ENTER BODY WEIGHT: KGS. The FDA-approved adult dosage is 5 to 10 units IM or subcutaneously every 3 to 4 hours or 2 to 3 times per day as needed with recommendation to reduce the dose proportionately for pediatric patients. Epinephrine: (Minor) . Knowing this is very important because lidocaine has a maximum dose that can be injected into a patient. Ordered dose = 4mcg/min Dosage strength = 1mg epinephrine in 500ml of 5% D/W = 1mg ÷ 500ml = .002mg/ml Infusion rate equation for Epinephrine (in ml/hr) = (ordered dose in mcg/min * 60) ÷ (dosage strength in solution in mg/ml * 1000) = (4*60) ÷ (0.002*1000) = 240 ÷ 2 = 120 ml/hr Try this. 2%+1:100,000 epinephrine 60 170 85 190 2%+1:20,000 levonordefrin 50 130 75 185 Articaine 7.0 3.2 500 4%+1:100,000 epinephrine 60 190 90 230 Prilocaine 6.0 2.7 400 4% plain 20 105 55 190 4%+1:200,000 epinephrine 40 140 60 220 Bupivacaine 1.3 0.6 90 0.5%+1:200,000 epinephrine 40 340 240 440 0.5 mg/kg/dose inhalation every hour PRN Mix dose (as needed) with 0.9% sodium chloride to provide a total volume of 2.5 mL for nebulization Maximum: 2.5 mg/dose Go to Pediatric Drug Dosing Guideline for EPINEPHrine . IV epinephrine every 3-5 minutes. 6.6 - not to exceed 400 mg per dose if with levonordefrin - not to exceed 500 mg per dose if with epinephrine. We did not find any eligible studies comparing different doses of intravenous epinephrine, but one study {Halling 2017 232} in which 30 neonates received initial ET epinephrine allowed a post hoc comparison of 30 infants who received two different doses of endotracheal epinephrine (0.03 vs 0.05 mg/kg/dose) in different epochs of the study . See here. Alt: 0.1 mg/kg/dose (1:1000 solution) ETT q3-5min prn; Max: 1 mg/dose IV/IO, 2.5 mg/dose ETT; Info: flush ETT dose w/ 5 mL NS and follow w/ 5 ventilations; IV/IO preferred to ETT route; optimal ETT dose unknown; higher doses may be needed if beta blocker or calcium channel blocker overdose; see PALS: Bradycardia table The dose required is 100 mg/kg/day given IV once daily and the drug comes prediluted in a concentration of 40 mg/mL. Complexity increases risk. Incompatible with bicarbonate and alkaline solutions. Repeated doses may be required. Intranasal dosage. Mechanism of action. Plasma epinephrine levels were measured during each route of drug administration and used to calculate steady-state epinephrine clearance rate and to compare cardiovascular responses with plasma levels. Epinephrine - Simply Easy NRP Epinephrine Posted on September 30, 2014 by admin-hearts Give rapidly Concentration 1:10,000 (0.1 mg/ml) ETT dose 0.5 - 1 ml/kg UVC / IV dose 0.1 - 0.3 ml/kg Follow with a 0.5 - 1 ml flush NS Re-check HR after 1 minute of compressions and ventilations Maybe longe if given through ETT Repeat dose every 3 - 5 minutes The optimal dosage of epinephrine for infants and children during advanced life support remains controversial. - not to exceed 400 mg per dose - maximum 1000 mg/24h. Patient Name: Owner Name: Species: Canine Feline. Note IV high-dose epinephrine (0.1 mg/kg) is no longer recommended for routine use in resuscitation. A Duration of anesthesia varies greatly depending on concentration, total dose, and site of administration; use of epinephrine; and the patient's age. Dose and Indications Epinephrine is used in foal resuscitation and cardiopulmonary resuscitation of newborn foals. Volumetric Dosing of EPINEPHrine for Neonates Could Lead to Dosing Errors September 22, 2016 Hospitals that have a neonatal intensive care unit (NICU), or that otherwise care for neonates, may be using the current information from the American Academy of Pediatrics Neonatal Resuscitation Program (NRP) to guide emergency efforts. Intraosseous and intravenous administrations of epinephrine were compared in newborn lambs. Epinephrine is an endogenous compound formed from norepinephrine. The recommended IV dose and concentration of epinephrine for the newborn is: asked Dec 13, 2021 in Nursing by elito76elito medical-surgical-health-assessment-critical-care Calculate â ¦ So the dose for epi in neonatal resuscitation is 0.01 to 0.03 mg/kg IV as published in the AHA 2010 guidelines. Convert the mg dose to mL: 2-2.5 - not to exceed 175 mg per dose - maximum 400 mg/24h. i forget source, but minimum dose in peds is 200 mcg IVP, regardless of weight. Based on animal data, and to simplify the required calculations [ 15, 24 ], we suggest using 0.1 mg/kg or 1 ml/kg of 1 mg/10 ml epinephrine for endotracheal administration to newborns with. • Consider pneumothorax. Dosage and Administration Figure 2. Target Oxygen Saturation Table Initial oxygen concentration for PPV 1 min 60%-65% 2 min 65%-70% 3 min 70%-75% 4 min 75%-80% 5 min 80%-85% 10 min 85%-95% ≥ 35 weeks' GA 21% oxygen Lower doses should be used in very vascular areas. I.V. Cephalexin No neonatal dosing available Treatment for skin/soft tissue infections (MSSA infections): 50 mg/kg/day divided q6-8 hours UT Prophylaxis: 10-20 mg/kg/dose PO QHS 1st generation cephalosporin Can alternate with or change to Bactrim at 2 months of life for UTI prophylaxis Clindamycin 5 to 7.5mg/kg/dose IV, PO Some experts use 0.5 mL/dose for all patients, regardless of size. The current recommended epinephrine dose by the neonatal resuscitation program (NRP) is 0.01-0.03 mg/kg IV or IO and 0.05-0.1 mg/kg through the ETT . The timeline during neonatal resuscitation for the invasive procedures of intubation or venous access is 45-60 seconds to administer the first dose of epinephrine (NRP, 2011). 2,3 It is 4mg/kg/dose (up to 300mg per dose) without epinephrine and 7mg/kg/dose (up to 500mg per dose) with epinephrine. Epine … Dose by Weight (mg/day) = Adult Dose in mg/kg or mg/kg/day x Child Weight in kg. Complexity increases risk. For anaphylaxis, the auto-injectors come in a dose of 0.15mg for people 15-30kg of weight and 0.3mg SC/IM x 1 for people >30 Kg. Titrate dose to desired response, not to exceed 1.0 µg/kg/min. 2ml of lidocaine 1% and Epinephrine 1:100,000 has 20mg of lidocaine and 0.002mg of epineprine. Note: Absorption is greater with distilled water, but causes . Injectable Perianesthetic Medications for Canine/Feline. The dose required is 100 mg/kg/day given IV once daily and the drug comes prediluted in a concentration of 40 mg/mL. ADVANCED LIFE SUPPORT (ALS) DRUG/CONCENTRATION/DOSE RANGE Epinephrine 1:10,000 preparations are available in pre-filled syringes packaged for adult doses of 1 mg/10 mL. Average dosing intervals were categorized as 1-5min, >5 to <8min, and 8 to <10min/dose. Team debrie˜ng. Epinephrine . o 5Maximum concentration 6 mg/mL o Low-stiction syringe recommended, but do not withhold treatment if unavailable • Infuse via CVL, UVC or large peripheral vein Divide the dose by the frequency: 1800 mg/day ÷ 1 (daily) = 1800 mg/dose. may be more effective than a dose of dopamine at > 15 µg/kg/min. AUVI-q 0.1 mg For infants and toddlers 29 weighing 16.5 lbs to 33 lbs; AUVI-Q 0.15 mg For children 29 weighing 33 lbs to 66 lbs; AUVI-Q 0.3 mg For anyone 29 weighing 66 lbs or more; AUVI-Q dosage strengths for infants/toddlers, children, and adults are determined by patient weight. Example: The clinician is treating a hypotensive patient with an epinephrine (adrenaline) infusion at 2 mcg/min. With a simple process & basic info, by using this drug dosage calculations app you can avoid all of the common problems when calculating drug doses! Worldwide, approximately 10 million infants per year require resuscitation at birth, which may include interventions such as stimulation, oxygen and positive pressure ventilation, or in the most severe cases chest compressions (CC) and drugs such as epinephrine.1 The proportion of infants receiving epinephrine during neonatal resuscitation is difficult to define. Birth 1 minute If HR remains <60 bpm, • Consider hypovolemia. To calculate the child's prescription you need to know an accurate weight for the child in kilograms and then multiply this by the dosage specified. For example, if the child's weight was 12kg then the dose required would be 10mg/kg x 12kg = 120mg. Team debrie˜ng. • The initial dose should be 10 ml/kg over 5-10 minutes • This dose may be repeated as needed • Dopamine should be started at this point • The use of Dopamine should be considered as first line therapy • Especially in premature infants • Especially when the etiology is unknown For information on adrenaline (epinephrine) for resuscitation, see adrenaline (epinephrine) (diluted) .1mg/mL for resuscitation . A single study examining incremental doses of epinephrine in a neonatal ovine model of asphyxial CA demonstrated systemic hypertension and low cardiac output at a dose of 0.1 mg/kg . Nebulisation: Using Respirator Solution .05mL/kg/dose Using 1 in 1000 ampoule only .5mL/kg/dose Dilute to 2-4mL with saline. This pediatric dose calculator is also able to compute the quantity of solution to be administered (both daily and per dose), given the pediatric dosage required. Step 1. Maximum single dose 50 mg Epinephrine 1:1,000 0.01 mg/kg IM thigh (0.01 mL/kg) Maximum single dose 0.3 mg (0.3 mL) Epinephrine autojector (Epi-pen) 0.3 mg IM thigh for 30 kg or greater Epinephrine autojector Jr (Epi-pen Jr) 0.15 mg IM thigh for 10-30 kg Magnesium sulfate 25-75 mg/kg IV/IO Maximum single dose 2 grams Dilute to less than 60 . Average epinephrine dosing interval was defined by dividing duration of resuscitation after first dose of epinephrine by total doses. Epinephrine 1:10,000 0.005 mg/kg (.05 mL) IV/IO every 10 minutes for persistent hypotension If the average weight of a newborn child is 3.5kg, what dose of Epinephrine (1:10,00) would you expect to give if there was persistent hypotension after child birth? 3-20: 45-90 [60-330 w/ levonordefrin, 120 w/ epinephrine] Bupivacaine. -Maximum dose: 1 mg. Endotracheal: 0.1 mg/kg (0.1 mL/kg of 1:1000 injectable solution) via endotracheal tube once, flush with 5 mL normal saline and follow with 5 ventilations; may repeat . The clinician needs to obtain the bag of fluid and the vial of epinephrine. Start at D10 1/4 NS at 3 mL/kg/hr which approximates hourly maintenance rate, leaving them slightly dry to administer IV meds. The paramedic administered 2 Sub-Q injections of epinephrine and 1 dose of diphenhydramine by IV push. Step 3. Epinephrine 1:10,000 concentrations are available in a pre-filled, single use (10 mL) syringe formulated and packaged for adult doses of 1.0 mg/10 mL (Broussard, 2010). Dobutamine and Dopamine Dosing Calculator Both of these tools calculate based on weight (kg/lb) and the initial dosing. o Epinephrine Protocols for managing hypoglycemia . lidocaine with epinephrine.12,20,21 Clark's rule is another weight-based method for calculating the MRD.12 According to Clark's rule, the dose of local anesthetic should be reduced by the ratio of the child's weight to an adult weight of 150 lb.5 Thus, if a child weighs 50 lb, then he/she is 33% of the established adult weight. Endotracheal: May be administered endotracheally (bolus dose only) if IV or intraosseous access unavailable at a dose of 2 to 3 times the dose (2 to 3 mg/kg) followed by a flush with at least 5 mL of NS and 5 consecutive . Note: Previous versions of Goldfrank's reported an increased maximum allowable dosage due to the vasoconstrictive effects of epinephrine when added to local anesthetics. For example, if the amount of medication per dose is 200 mg and the amount of medication per tablet is 100 mg, divide 200 by 100 to get the number of tablets that should be administered per dose. Initial dose 0.05 µg/kg/min. Post-resuscitation care. IV epinephrine every 3-5 minutes. An epinephrine auto-injector designed to go and grow with your patients. 0.05 to 0.1 mL/kg/dose of 2.25% racemic epinephrine solution (Max: 0.5 mL/dose) diluted in 2 to 2.5 mL of normal saline and given via nebulizer; may repeat every 20 minutes as needed. -Maintenance infusion: 20 to 50 mcg/kg/min IV. NB: The ACLS dose of epinephrine is 1mg IV/IO q3-5 min prn. Post-resuscitation care. Divide the dose by the frequency: 1800 mg/day ÷ 1 (daily) = 1800 mg/dose. A) 0.25 mg B) 0.055 mg C) 0.025 mg D) 0.55 mg. Step 3. In the early epinephrine literature, asthma was treated in adults with 1-mg doses and in infants weighing 25 pounds with 1/16th of the adult dose. field for calculation. Lidocaine Dosage: % to mg/ml. As an ophthalmic/adrenergic agonist, it is used for meiosis refractory and atropine treatment, and in the treatment of glaucoma. dose; dilute in 10 mL NS or distilled water. 2.5-3 - not to exceed . Adults. Open in a separate window. The mechanism of action in neonates is controversial. Doses should be decreased by 30 percent in infants younger than six months. Birth 1 minute If HR remains <60 bpm, • Consider hypovolemia. An epinephrine dose of 0.05 µg/kg/min. • 150lbs/ 2.2lbs per kg= 68.2 kg. The AHA recommends: IV: -Initial dose: 1 mg/kg IV or intraosseous once. The formula would yield 30 gtt/min. E.g. Intraosseous and intravenous administrations of epinephrine were compared in newborn lambs. Racepinephrine can be ordered by the physician more frequently than Q2 hrs if the patient is worsening and MD bedside evaluation is in Neonatal intensive care, expert sources advise dilute 3 mg/kg body-weight to a final volume of 50 mL with infusion fluid; an intravenous infusion rate of 0.1 mL/hour provides a dose of 100 nanograms/kg/minute; infuse through a central venous catheter. Everything else, the dose of epinephrine must be less than that. Infants and Children: -IV or intraosseous: 0.01 mg/kg (0.1 mL/kg of 1:10,000 injectable solution) IV or intraosseous once; may repeat every 3 to 5 minutes. o 5Maximum concentration 6 mg/mL o Low-stiction syringe recommended, but do not withhold treatment if unavailable • Infuse via CVL, UVC or large peripheral vein It can be administered every 3 to 5 minutes as needed. Medications for Neonatal Resuscitation Program 2011 Canadian Adaptation Medication Concentration Preparation Dose/Route Weight/Dose Rate Epinephrine ET 1: 10,000 Draw up in a . Epinephrine Infusion Calculator. Drug Conc. i'll verify and repost. Pediatric Dose Formulas. 9 While attempting placement of a UVC, a dose of endotracheal epinephrine may be administered at a dose of 0.05 to 0.1 mg/kg. B Use lowest total dose that provides effective anesthesia. Dose range. While there likely is a higher safe dose when epinephrine is added, we no longer include that estimate on this calculator, and as always, dosages should be double . : 1 mg every 3-5 minutes; if this approach fails, higher doses of epinephrine (up to 0.2 mg/kg) may be used, but are not recommended (Class Indeterminate; 2000 ACLS guidelines) Intratracheal: Administer 2-2.5 times the recommended I.V. Amount of epinephrine to add to diluent (mg) Volume of epinephrine injection (1:1000 i.e. Plasma epinephrine levels were measured during each route of drug administration and used to calculate steady-state epinephrine clearance rate and to compare cardiovascular responses with plasma levels. Results are in mcg/kg/min with the selected solution. For example, if the child's weight was 12kg then the dose required would be 10mg/kg x 12kg = 120mg. Tachycardia, hypertension 2. alpha and beta adrenergic, and dopaminergic receptor functions. Calculate the dose in mg: 18 kg × 100 mg/kg/day = 1800 mg/day. Dose by BSA (mg/day) = Adult Dose in mg/day x BSA in m 2 / 1.73. (D10 at 1 mL/hr = 1.67 mg/kg/min of dextrose). lidocaine with epinephrine.12,20,21 Clark's rule is another weight-based method for calculating the MRD.12 According to Clark's rule, the dose of local anesthetic should be reduced by the ratio of the child's weight to an adult weight of 150 lb.5 Thus, if a child weighs 50 lb, then he/she is 33% of the established adult weight. Cephalexin No neonatal dosing available Treatment for skin/soft tissue infections (MSSA infections): 50 mg/kg/day divided q6-8 hours UT Prophylaxis: 10-20 mg/kg/dose PO QHS 1st generation cephalosporin Can alternate with or change to Bactrim at 2 months of life for UTI prophylaxis Clindamycin 5 to 7.5mg/kg/dose IV, PO Epinephrine was administered at a dose of 0.5 to 5 . GLUCOSE REQUIREMENTS FOR NEONATES AND INFANTS Normal blood glucose for newborns 40-60 mg/dL. Since we want to be safe, before injecting / infiltrating the local anesthetic, it is good practice to calculate the safe "upper limit" dose.. Lidocaine w/o Epi - 5 mg/kg of Lidocaine [Berde, 1993]; Lidocaine w/ Epi - 7 mg/kg of Lidocaine [Berde, 1993]; Bupivacaine - 2 mg/kg [Berde, 1993]; Dose range may vary based on reference you use… these are well . That is the maximum dose of epinephrine that can be safely given. Advantages are shown in blue and disadvantages in red. A high dose of epinephrine (0.2 mg/kg per dose) was given via umbilical arterial catheter in 3 preterm infants (28, 29, and 34 wk' gestation) on day 2-3 after birth. Once introduced into the neonatal setting, the opportunity for dire consequences becomes very real; adult doses are in milligrams while neonatal doses are in milliliters. Infants, Children, and Adolescents . • Consider pneumothorax. Drug dosage is a unique and very powerful application to calculate drug doses especially for drug doses in pediatric. Primary outcome was survival to hospital discharge. Test Dose for Caudal and Lumbar Epidural Blocks: The Test Dose of Bupivacaine Hydrochloride (0.5% bupivacaine with 1:200,000 epinephrine in a 3 mL ampul) is recommended for use as a test dose when clinical conditions permit prior to caudal and lumbar epidural blocks. Epinephrine is also added to local anesthetics to retard systemic absorption and prolong effect. if giving it for low HR (decreasing rapidly), i consider 100-200 mcg IVP. Older infants/children: 0.1 mg/kg of 1:1000 solution (maximum: 10 mg). Step 2. The patient is suffering an anaphylactic reaction. Neonatal Intensive Care Unit Basic Medication Administration Examination (NICU BMAE) Study Guide Page 1 of 3 . Epinephrine Dosing Calculator — Adult & Pediatric The adult calculator displays recommendations based on initial dosing and the solution concentration. Introduction. Upper airway obstruction 2. Step 2. infiltration, subcutaneous. Responses tend to be . Infographic showing alternative routes of epinephrine administrations. Tab or click out of Body Weight. To calculate the child's prescription you need to know an accurate weight for the child in kilograms and then multiply this by the dosage specified. Average dosing intervals were categorized as 1-5min, >5 to <8min, and 8 to <10min/dose. depends on what you're using it for (how you're using it): typical calculation i usually have for peds is 0.01-0.03 mg/kg (for infusion/bradycardia IVP). the ability of the neonatal heart to increase stroke volume. Rather than administering 0.3 mL of 1:1,000 epinephrine concentration intramuscularly (equivalent to 0.3 mg, the correct dose, concentration, and route for treating anaphylaxis), 1 mL of 1:1,000 concentration was administered intravenously (equivalent to 1mg, the correct dose and route for cardiac resuscitation, but 10 times the recommended . Newborn infants: 0.03-0.10 mg/kg of 1:10 000 solution. Consecutive children in cardiac arrest given a high dose of epinephrine (0.2 mg/kg) after failure to respond to 2 doses of 0.01 mg/kg. This may serve as a warning of unintended intravascular or subarachnoid injection. . The neonatal epinephrine dose is 0.01 to 0.03 mg per kg (1:10,000 solution) given intravenously (via umbilical venous catheter).1, 2, 5, 6 If there is any delay in securing venous access . 3 AVAILABLE DOSAGES. Table 1: Formulas to calculate drug volumes (mls) for single shot caudal epidural block (see also table 3) Local anesthetic* dose (mls) Estimated sensory Level 1 % Lignocaine .06ml/segment Mid-Thoracic (T8) 0.25% Bupivicaine 1ml/kg Mid-Thoracic (T8) 0.175% Bupivicaine 1.25 ml/kg Mid Thoracic (T8) Wt of infant (kg) Dose (range 0.1-1.0 microgram/kg/min) Flow rate (ml/hr) Volume of infusion to be made up (ml) Diluent: 5% or 10% glucose or 0.9% sodium chloride. If the dose is expressed using the volume method, the provider preparing the dose does not have to convert between units, but there is a risk of giving a 10-times overdose if the provider accidently uses the concentrated (1 mg/mL) epinephrine solution. They use one vial of epinephrine 1:1,000, place it into a 250 mL bag of normal saline (NS), and use a 60 gtt/set. The current edition of the Neonatal Resuscitation Program textbook recommends administering epinephrine at a dose of 0.01 to 0.03 mg/kg through a low UVC followed by a flush of 0.5 to 1 mL of normal saline. Guidelines for use of Epinephrine, Racemic (Racepinephrine ) Recommended Neonatal Dose, Route, and Interval 0.25 ml of 2.25% solution/dose diluted to 3 ml with normal saline. n Start with weight, assuming ASA 1. ABOUT AUVI-Q. DOSAGE CALCULATOR. 9 We elected . The most recent version no longer includes this adjustment. 0.1 - .3mL/kg/dose For ease of calculation in an acute resuscitation a dose of 1mL may be given in a term infant and 0.5mL in a preterm infant. Average epinephrine dosing interval was defined by dividing duration of resuscitation after first dose of epinephrine by total doses. Epinephrine is used for cardiac arrest (with or without a pulse), asystole, symptomatic bradycardia, and hypotension unrelated to volume depletion. Your patient has an order for Epinephrine 2mcg/min. Convert the mg dose to mL: EPINEPHRINE- epinephrine injection, solution . This guideline uses the undiluted 1mg/mL form and it requires diluting prior to intravenous infusion. I just haven't used it enough to be comfortable hubbing a long needle all the way through the roof of the mouth. Follow ET administration with saline flush or dilute in isotonic saline (1-5 mL) based on patient size.
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how to calculate epinephrine dose for neonates