← Chapter 11
Maternal-Newborn & Paediatric Nursing · Chapter 11 · Section 5

Per Kilogram, Per Hour, Per Age Band

Three calculations carry the safety of paediatric practice. Every dose is mg/kg, written out, and capped at the maximum adult dose. Every fluid rate comes from the 4-2-1 rule. And every vital sign is read against the child’s own age band, because tachycardia is the earliest sign of shock and hypotension is a late, pre-terminal one. Change a weight and watch the arithmetic redo itself line by line; change a heart rate and watch a normal blood pressure stop being reassuring.

Set up the child

In an emergency, use a length-based resuscitation tape. If none is available, a serviceable estimate for children one to ten years is weight in kg = (age in years × 2) + 8. A stated or remembered weight is not acceptable for a calculated dose once the emergency is over.

Show the arithmeticEvery line written out, every ceiling checked
Waiting
Choose a mode on the left.