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Pediatric Calculation Technique

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Pediatric calculations

Accurate doses are especially important in giving medications to infants and children because even small errors can be dangerous due to their small body size.
Two methods are used to calculate pediatric dosages: According to the weight in kilograms (kg) According to the child's body surface area (BSA) Calculations based on body weight
1. The first step is to convert the child's body weight into kg. The formula is 2.2 lb. = 1 kg.
2. The second step is to calculate the medication dose. a. Calculate the daily dose b. Divide the daily dose by the number of doses to be administered. c. Use either the ratio-proportion or formula method to calculate the number of tablets/ capsules or volume to be administered with each dose.
Example: A child weighing 76 lbs. is ordered to receive 150 mg of Clindamycin q6h. The pediatric drug handbook states the recommended dose is 8-20 mg/kg/day in four divided doses. The Clindamycin is supplied in 100 mg scored tablets.
1. What is the weight in kg? 76 lbs÷2.2kg/lb. = 34.5 kg
2. What is the safe total daily dose? Minimum: 8 mg/kg/day X 34.5 kg = 276 mg/day Maximum: 20 mg/kg/day X 34.5 kg = 690 mg/day
3. Is this a safe dose?
150 mg/dose X 4 doses/day = 600 mg/day
Yes this is within the recommended safe range.
4. Calculate the number of tablets to give. 100 mg: 1 tablet = 150 mg: x (multiply means 100 x = 150 & extremes) x = 1.5 tablets Calculations based on Body Surface Area (BSA)
BSA is determined from a monogram using the child's height and weight.
When you know the child's BSA the dosage is determined by multiplying the BSA by the recommended dose.
To determine whether the dose is safe, compare the ordered dose and the calculation based upon the BSA.
The formula for calculating child's dosage is Child's BSA X adult dosage 1.7 M2
Example: The child has a BSA of 0.67 M2. The adult dose is 40 mg. The physician ordered 8 mg. Is the dosage correct? 0.67 X 40 = 26.8 = 15.8 mg No, the dose is 1.7 1.7 too small.
How to calculate amount of fluids IV to be administered to newborns and infants:

It is a 4, 2, and 1 per hour formula: 4 cc/kg for the first 10kg of body weight 2 cc/kg for the second 10kg of body weight 1cc/kg for every kilogram over the first 20 Example: The rate for a 25kg child is 4x10 =40 plus 2x10 =20 plus 1x5 =5, for an IVF rate of 65 cc/hr.

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