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Treatment Protocol 4102 Effective
April 1, 2021 Expires
March 31, 2022 Policy:
Calculation Chart Approval: Medical Director
Reza Vaezazizi, MD Signature
Applies To: PSP, EMT, AEMT, EMT-P, MICN, BHP, EMS
System Approval: REMSA Administrator
Trevor Douville Signature
4102 — Calculation Chart (4/1/21 - 15:37) 1 of 18
PURPOSE The purpose of this policy is to standardize medication dosages and volumes, airway sizes, and energy settings for cardioversion and defibrillation.
AUTHORITY California Health and Safety Code - Division 2.5: Emergency Medical Services [1797. - 1799.207.] California Code of Regulations, Title 22. Social Security, Division 9. Prehospital Emergency Medical Services Required Equipment A commercially available, standardized Length Based Resuscitation Tape with colors / kgs corresponding to this chart, and a laminated copy of this treatment protocol, are required field equipment. This chart must be color printed, front and back, at full size, and carried in each first response and transport vehicle. Determining Age, Weight, and Height Determine a patient’s age, weight, and height:
1. Age by written record, report by patient or parent, or estimate by EMS 2. Weight by measurement, written record, report by patient or parent, Length Based Resuscitation Tape, or
estimate by EMS 3. Height by measurement, written record, report by patient or parent, or estimate by EMS
Pediatric Patient A pediatric patient is defined as a person appearing, or known to be, 14 years of age or less Calculation Chart Orders are not obtained from the Calculation Chart, they are obtained through an indicated treatment protocol, or a base hospital order (BHO). This chart is to be used when calculating medication dosing, airway adjunct size, and cardioversion/defibrillation energy settings. The process is:
1. Determine the patient’s age, weight, and height 2. Utilize a Length Based Resuscitation Tape to determine the appropriate color in the pediatric patient 3. As directed by an indicated treatment protocol, or a BHO, use this chart to calculate medication dosage and
volume: a. Obtain the order, route, and any adjustments through an indicated treatment protocol or a BHO b. Use only REMSA authorized medications in the required concentrations as found in policy #3301 (Drug
and Equipment List) c. Use a 1 mL syringe, graduated in tenths and hundredths, for indicated volumes less than 1 mL d. When available, have a second qualified person verify dosage prior to administration
4102 — Calculation Chart (4/1/21 - 15:37) 2 of 18
4. Notice the following annotations: a. Specific routes and relationships may be identified on the Calculation Chart by an attached annotation
as follows: i. “CPAP” identifies a dose related only to administration of CPAP by mask
ii. “IV”, “IM”, “IN”, “TD”, and “SL” identify the corresponding route 1. “IV” may refer to IV and IO; push, bolus, or drip; as indicated by the actual order
iii. “IM x 2” identifies a dose given twice by the IM route, once per site, as a single dose iv. “IN x 2” identifies a dose given twice by the IN route, once per nostril, as a single dose
b. Volumes given to the hundredth are identified by black underline as seen with Diazepam, Epinephrine 1:1,000, Fentanyl, Lorazepam, Midazolam, and Morphine Sulfate
5. For Push Dose Epinephrine dosing. Create the required dilution of epinephrine by:
a. Utilizing aseptic technique obtain 1mL of epinephrine (0.1 mg/mL) preparation b. Utilizing aseptic techniques obtain 9 mL of normal saline c. Mix the 1 mL of the 0.1 mg/mL epinephrine with the 9 mL of normal saline in an aseptic manner. d. Label the new concentration of epinephrine as 0.01 mg/mL and utilize per protocol. e. For pediatric patients administer 0.1 mL/kg of the diluted epinephrine; for adults administer 1 mL of the
diluted epinephrine per protocol.
6. In the absence of Atropine in prefilled syringes, Atropine 1 mg / 1 mL may be diluted at the point of care: a. Dilute to Atropine 1 mg in 10 mL
i. Draw up 1 mL Atropine 1 mg / 1 mL ii. Draw up additional 9 mL Normal saline (NS)
iii. Yields Atropine 1 mg in 10 mL
7. In the absence of Dextrose 10% or Dextrose 25%, Dextrose 50% (D50) may be diluted at the point of care: a. Dilute to Dextrose 10% (5 g in 50 mL)
i. Expel 40 mL from the 50mL prefilled syringe of Dextrose 50% (D50) ii. Draw up 40 mL Normal saline (NS)
iii. Yields 5 g Dextrose 10% in 50 mL b. Dilute to Dextrose 25% (12.5 g in 50 mL)
i. Expel 25 mL from the 50mL prefilled syringe of Dextrose 50% (D50) ii. Draw up 25 mL Normal saline (NS)
iii. Yields 12.5 g Dextrose 25% in 50 mL
8. In the absence of Epinephrine 1:10,000 in prefilled syringes, Epinephrine 1:1,000 1 mg / 1 mL may be diluted at the point of care:
a. Dilute to Epinephrine 1:10,000 1 mg in 10 mL i. Draw up 1 mL Epinephrine 1:1,000 1 mg / 1 mL
ii. Draw up additional 9 mL Normal saline (NS) iii. Yields Epinephrine 1:10,000 1 mg in 10 mL
9. As directed by an indicated treatment protocol, or a BHO, use this chart to calculate energy settings and airway
adjunct size
10. Contact a base hospital for orders in case of atypical presentation, circumstance, or uncertainty. This includes pediatric patients less than 3 kg, and adult patients less than 36 kg (80 lbs) / 4 feet 10 inches.
11. In case of a nerve agent attack and/or deployment of a CDC CHEMPACK:
a. Patient classification: i. Classify atypical pediatric patients less than 3 kg as Length Based Resuscitation Tape Grey
ii. Classify atypical adult patients less than 36 kg (80 lbs) / 4 feet 10 inches using the Length Based Resuscitation Tape
4102 — Calculation Chart (4/1/21 - 15:37) 3 of 18
b. Pralidoxime Chloride: i. For IM use reconstitute Pralidoxime Chloride with only 5 mL sterile water to 1000 mg / 5 mL
1. DO NOT GIVE THIS CONCENTRATION IV/IO! ii. For IV use reconstitute Pralidoxime Chloride with the full 20 mL sterile water to 1000 mg / 20 mL
1. When given IV/IO, Pralidoxime should be given as a bolus drip in 50 mL over 10 minutes! Pralidoxime Chloride is distributed as 1000 mg powder in a 20 mL vial requiring reconstitution with sterile water; note the varying concentrations of Pralidoxime Chloride in the chart that follows:
4102 — Calculation Chart (4/1/21 - 15:37) 4 of 18
Preferred Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Activated Charcoal PO PO PO PO PO PO PO PO PO PO 50 g 25 g 4.2 g 6.3 g 8.3 g 10.4 g 12.5 g 16.7 g 20.8 g 27 g 33.3 g 50 g
240 mL 120 mL 20 mL 30 mL 40 mL 50 mL 60 mL 80 mL 100 mL 130 mL 160 mL 240 mL Adenosine IV IV IV IV IV IV IV IV IV IV
12 mg 6 mg 0.6 mg 1.2 mg 1.8 mg 1.8 mg 2.4 mg 3 mg 4.2 mg 5.4 mg 6.6 mg 12 mg 4 mL 2 mL 0.2 mL 0.4 mL 0.6 mL 0.6 mL 0.8 mL 1 mL 1.4 mL 1.8 mL 2.2 mL 4 mL
Albuterol 0.083% NEB NEB NEB NEB NEB NEB NEB NEB NEB NEB 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL
Amiodarone (OHCA) IV IV IV IV IV IV IV IV IV IV 150 mg 900 mg 20 mg 35 mg 45 mg 50 mg 65 mg 85 mg 105 mg 135 mg 165 mg 300 mg
3 mL 18 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.3 mL 6 mL Amiodarone IV IV IV IV IV IV IV IV IV IV
(OHCA) Repeat 20 mg 35 mg 45 mg 50 mg 65 mg 85 mg 105 mg 135 mg 150 mg 150 mg 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3 mL 3 mL
Amiodarone (BHO) VT or SVT w/ pulses IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB 150 mg 900 mg 20 mg 35 mg 45 mg 50 mg 65 mg 85 mg 105 mg 135 mg 150 mg 150 mg
3 mL 18 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.0 mL 3 mL Aspirin PO 81 mg None None None None None None None None None 324 mg
1 tablet 4 tablets Atropine IV IV IV IV IV IV IV IV IV IV
1 mg 0.5 mg 0.08 mg 0.13 mg 0.17 mg 0.2 mg 0.26 mg 0.33 mg 0.42 mg 0.5 mg 0.5 mg 0.5 mg 10 mL 5 mL 0.8 mL 1.3 mL 1.7 mL 2 mL 2.6 mL 3.3 mL 4.2 mL 5 mL 5 mL 5 mL
Atropine (MDV) IM IM IM IM IM IM IM IM x 2 IM x 2 IM x 2 8 mg 0.2 mg 0.32 mg 0.44 mg 0.52 mg 0.64 mg 0.84 mg 1 mg 0.68 mg 0.84 mg 1 mg 20 mL 0.5 mL 0.8 mL 1.1 mL 1.3 mL 1.6 mL 2.1 mL 2.5 mL 1.7 mL 2.1 mL 2.5 mL
Calcium Chloride 10% IV IV IV IV IV IV IV IV IV IV 1 g 80 mg 130 mg 170 mg 200 mg 260 mg 330 mg 420 mg 540 mg 660 mg 1 g
10 mL 0.8 mL 1.3 mL 1.7 mL 2 mL 2.6 mL 3.3 mL 4.2 mL 5.4 mL 6.6 mL 10 mL Dextrose 10% IV IV IV IV IV IV IV IV IV IV
1 g 2 g 3 g 4 g 5 g 6.5 g 8 g 10.5 g 13.5 g 16.5 g 25 g 10 mL 20 mL 30 mL 40 mL 50 mL 65 mL 80 mL 105 mL 135 mL 165 mL 250 mL
4102 — Calculation Chart (4/1/21 - 15:37) 5 of 18
Preferred Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Dextrose 25% IV IV IV IV IV IV IV IV IV 2.5 g None 3.25 g 4.25 g 5 g 6.5 g 8.25 g 10.5 g 13.5 g 16.5 g 25 g
10 mL 13 mL 17 mL 20 mL 26 mL 33 mL 42 mL 54 mL 66 mL 100 mL Dextrose 50% IV IV IV IV IV
25 g None None None None None 8.25 g 10.5 g 13.5 g 16.5 g 25 g 50 mL 16.5 mL 21 mL 27 mL 33 mL 50 mL
Diphenhydramine IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 50 mg 5 mg 5 mg 10 mg 10 mg 15 mg 15 mg 20 mg 25 mg 35 mg 50 mg 1 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 1 mL
Epinephrine 1:1,000 IM IM IM IM IM IM IM IM IM IM 1 mg 30 mg 0.04 mg 0.07 mg 0.09 mg 0.1 mg 0.1 mg 0.2 mg 0.2 mg 0.3 mg 0.3 mg 0.3 mg 1 mL 30 mL 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.3 mL
Epinephrine 1:10,000 IV IV IV IV IV IV IV IV IV IV 1 mg 0.04 mg 0.07 mg 0.09 mg 0.1 mg 0.13 mg 0.17 mg 0.21 mg 0.27 mg 0.33 mg 1 mg
10 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.3 mL 10 mL Epinephrine 1:100,000 Push IV IV IV IV IV IV IV IV IV IV
0.01 mg Dose 0.004 mg 0.007 mg 0.009 mg 0.01mg 0.01mg 0.01mg 0.01mg 0.01mg 0.01mg 0.01mg 1 mL Epi 0.4 mL 0.7 mL 0.9 mL 1 mL 1 mL 1 mL 1 mL 1 mL 1 mL 1 mL
Fentanyl IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 100 mcg 4 mcg 6.5 mcg 8.5 mcg 10 mcg 15 mcg 15 mcg 20 mcg 25 mcg 30 mcg 50 mcg
2 mL 0.08 mL 0.13 mL 0.17 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.6 mL 1 mL Fentanyl - IN IN IN IN IN IN IN IN IN IN x 2 IN
4 mcg 6.5 mcg 8.5 mcg 10 mcg 15 mcg 15 mcg 20 mcg 25 mcg 15 mcg 50 mcg 0.08 mL 0.13 mL 0.17 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.3 mL 1 mL
Glucagon IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 1 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 1 mg 1 mg 1 mg 1 mg 1 mg 1 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 1 mL 1 mL 1 mL 1 mL 1 mL
Glucose Gel PO PO PO PO PO PO PO PO PO PO 1 Tube 4 mL 7 mL 9 mL 10 mL 13 mL 1 tube 1 tube 1 tube 1 Tube 1 Tube
Ipratropium Bromide NEB NEB NEB NEB NEB NEB NEB NEB NEB NEB 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL
4102 — Calculation Chart (4/12/21 - 12:59) 6 of 18
Preferred Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Ketamine - IVPB IVPB
50 mg 500 mg Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
0.3 mg/kg
1 mL 5 mL +IVPB NS Ketamine - IN IN
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
0.5 mg/kg
Lidocaine 2% IV IV IV IV IV IV IV IV IV IV
100 mg 400 mg 4 mg 6 mg 8 mg 10 mg 14 mg 16 mg 22 mg 28 mg 34 mg 100 mg 5 mL 20 mL 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 5 mL
Lidocaine Repeat IV IV IV IV IV IV IV IV IV IV 4 mg 6 mg 8 mg 10 mg 14 mg 16 mg 22 mg 28 mg 34 mg 50 mg 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 2.5 mL
Conscious IO Pain IO IO IO IO IO IO IO IO IO IO 2 mg 4 mg 4 mg 6 mg 8 mg 8 mg 12 mg 14 mg 18 mg 50 mg 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.4 mL 0.4 mL 0.6 mL 0.7 mL 0.9 mL 2.5 mL
Magnesium Sulfate IV IV IV IV IV IV IV IV IV IV 5 g 1 g 0.2 g 0.35 g 0.45 g 0.5 g 0.65 g 0.85 g 1.05 g 1.35 g 1.65 g 2 g
10 mL 2 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.3 mL 4 mL IVPB
Pre-Eclampsia/Eclampsia None None None None None None None None None 5 g In 50 mL over 10 min. 10 mL
Pre-Eclampsia/ IM x 2 Eclampsia IM None None None None None None None None None 2.5 g
5 mL Midazolam IV IV IV IV IV IV IV IV IV IV
5 mg 10 mg 0.2 mg 0.35 mg 0.45 mg 0.5 mg 0.5 mg 1 mg 1 mg 1.5 mg 1.5 mg 2.5 mg 1 mL 2 mL 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.5 mL
Midazolam – IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN 0.4 mg 0.7 mg 0.9 mg 1 mg 1 mg 2 mg 2 mg 3 mg 3 mg 5 mg 0.08 mL 0.14 mL 0.18 mL 0.2 mL 0.2 mL 0.4 mL 0.4 mL 0.6 mL 0.6 mL 1 mL
Anxiety related to the use None None None None None None None None None
1 mg of CPAP 0.2 mL
4102 — Calculation Chart (7/19/21 - 10:10) 7 of 18
Preferred Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Midazolam - Anxiety s/p BHO
ROSC & hyperthermia Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted 1 mg
induced shivering 0.2 mL Naloxone IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM
2 mg 0.4 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 2 mL 0.4 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL
Naloxone - IN IN x 2 IN IN IN IN IN IN IN IN IN 0.2 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg
0.2 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL Nitroglycerin SL
0.4 mg Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted 0.4 mg
1 tablet or Spray 1 tablet Nitro Paste 2% TD
1 g 30 or 60g Not
permitted Not
permitted Not
permitted Not
permitted Not
permitted Not
permitted Not
permitted Not
permitted Not
permitted 1 g
1 inch 1 Tube 1 inch Normal saline 0.9% IV IV IV IV IV IV IV IV IV IV
IV Solution 80 mL 130 mL 170 mL 200 mL 250 mL 250 mL 250 mL 250 mL 250 mL 250 mL 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus
Ondansetron ODT ODT ODT ODT ODT ODT ODT ODT 4 mg BHO BHO BHO 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg
1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet Ondansetron IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM
4 mg 0.4 mg 0.6 mg 0.8 mg 1 mg 1.4 mg 1.6 mg 2.2 mg 2.8 mg 3.4 mg 4 mg 2 mL 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 2 mL
Sodium Bicarb. 8.4% IV IV IV IV IV IV IV IV IV IV 50 mEq 10 mEq 4 mEq 6.5 mEq 8.5 mEq 10 mEq 13 mEq 16.5 mEq 21 mEq 27 mEq 33 mEq 50 mEq 50 mL 10 mL 4 mL 6.5 mL 8.5 mL 10 mL 13 mL 16.5 mL 21 mL 27 mL 33 mL 50 mL
Tranexamic Acid IVPB
1 gram Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted 1 gram
10 mL 10 mL
4102 — Calculation Chart (7/19/21 - 10:35) 8 of 18
Energy Settings Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Cardioversion Initial Shock 4j 7j 9j 10j 15j 20j 30j 30j 50j 100j
Subsequent Shocks 8j 15j 20j 20j 30j 50j 50j 70j 70j 150j, 200j Defibrillation
Initial Shock 8j 15j 20j 20j 30j 50j 50j 70j 70j Per Manu.
Subsequent Shocks 20j 30j 50j 50j 70j 70j 100j 120j 150j Per Manu.
Suction Catheter 6–8 Fr. 8 Fr. 8 Fr. 10 Fr. 10 Fr. 10 Fr. 10 Fr. 10 Fr. 10–12 Fr. 14–18 Fr. Oropharyngeal Airway 50 mm/0 50 mm/0 50 mm/0 60 mm/1 60 mm/1 60 mm/1 70 mm/2 80 mm/3 80 mm/3 90 mm/4
100mm/5 Nasopharyngeal Airway 14 Fr. 14 Fr. 16 Fr. 18 Fr. 20 Fr. 22 Fr. 24 Fr. 26 Fr. 28 Fr. 30–36 Fr.
Endotracheal Tube Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted 6.0-9.0
.
Cont
4102 — Calculation Chart (4/1/21 - 15:37) 9 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Activated Charcoal PO PO PO PO PO PO PO PO PO PO 50 g 25 g 4.2 g 6.3 g 8.3 g 10.4 g 12.5 g 16.7 g 20.8 g 27 g 33.3 g 50 g
240 mL 120 mL 20 mL 30 mL 40 mL 50 mL 60 mL 80 mL 100 mL 130 mL 160 mL 240 mL Adenosine IV IV IV IV IV IV IV IV IV IV
12 mg 6 mg 0.6 mg 1.2 mg 1.8 mg 1.8 mg 2.4 mg 3 mg 4.2 mg 5.4 mg 6.6 mg 12 mg 4 mL 2 mL 0.2 mL 0.4 mL 0.6 mL 0.6 mL 0.8 mL 1 mL 1.4 mL 1.8 mL 2.2 mL 4 mL
Albuterol 0.083% NEB NEB NEB NEB NEB NEB NEB NEB NEB NEB 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 2.5 mg 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL 3 mL
Albuterol MDI MDI MDI MDI MDI MDI 90 mcg None None None None None 180 mcg 180 mcg 180 mcg 180 mcg 180 mcg
1 Metered Dose (Puff) 2 Puffs 2 Puffs 2 Puffs 2 Puffs 2 Puffs Amiodarone IV IV IV IV IV IV IV IV IV IV
150 mg 900 mg 20 mg 35 mg 45 mg 50 mg 65 mg 85 mg 105 mg 135 mg 165 mg 300 mg 3 mL 18 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.3 mL 6 mL
Amiodarone Repeat IV IV IV IV IV IV IV IV IV IV 20 mg 35 mg 45 mg 50 mg 65 mg 85 mg 105 mg 135 mg 150 mg 150 mg 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3 mL 3 mL
Amiodarone (BHO) VT or SVT w/ pulses IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB 150 mg 900 mg 20 mg 35 mg 45 mg 50 mg 65 mg 85 mg 105 mg 135 mg 150 mg 150 mg
3 mL 18 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.0 mL 3 mL Aspirin PO 81 mg None None None None None None None None None 324 mg
1 tablet 4 tablets Atropine IV IV IV IV IV IV IV IV IV IV
1 mg 0.5 mg 0.08 mg 0.13 mg 0.17 mg 0.2 mg 0.26 mg 0.33 mg 0.42 mg 0.5 mg 0.5 mg 0.5 mg 10 mL 5 mL 0.8 mL 1.3 mL 1.7 mL 2 mL 2.6 mL 3.3 mL 4.2 mL 5 mL 5 mL 5 mL
Atropine (MDV) IM IM IM IM IM IM IM IM x 2 IM x 2 IM x 2 8 mg 0.2 mg 0.32 mg 0.44 mg 0.52 mg 0.64 mg 0.84 mg 1 mg 0.68 mg 0.84 mg 1 mg
20 mL 0.5 mL 0.8 mL 1.1 mL 1.3 mL 1.6 mL 2.1 mL 2.5 mL 1.7 mL 2.1 mL 2.5 mL Atropine - IV IV IV IV IV IV IV IV IV IV IV
0.2 mg 0.32 mg 0.44 mg 0.52 mg 0.64 mg 0.84 mg 1.04 mg 1.36 mg 1.64 mg 2 mg 0.5 mL 0.8 mL 1.1 mL 1.3 mL 1.6 mL 2.1 mL 2.6 mL 3.4 mL 4.1 mL 5 mL
4102 — Calculation Chart (4/1/21 - 15:37) 10 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Atropine IM IM IM IM IM IM IM IM IM IM 1 mg 0.2 mg 0.3 mg 0.4 mg 0.5 mg 0.7 mg 0.8 mg 1.1 mg 1.4 mg 1.7 mg 2 mg 1 mL 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 2 mL
Atropine - IV IV IV IV IV IV IV IV IV IV IV 0.2 mg 0.3 mg 0.4 mg 0.5 mg 0.7 mg 0.8 mg 1.1 mg 1.4 mg 1.7 mg 2 mg 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 2 mL
Atropine Autoinjector IM 2 mg None None None None None None None None None 2 mg
1 Autoinjector (AI) 1 AI Atropine Autoinjector IM IM IM IM IM
1 mg None None None None None 1 mg 1 mg 1 mg 1 mg 1 mg 1 Autoinjector (AI) 1 AI 1 AI 1 AI 1 AI 2 AI
Atropine Autoinjector IM IM IM IM IM IM IM IM IM IM 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg
1 Autoinjector (AI) 1 AI 1 AI 1 AI 1 AI 1 AI 2 AI 2 AI 2 AI 2 AI 4 AI Calcium Chloride 10% IV IV IV IV IV IV IV IV IV IV
1 g 80 mg 130 mg 170 mg 200 mg 260 mg 330 mg 420 mg 540 mg 660 mg 1 g 10 mL 0.8 mL 1.3 mL 1.7 mL 2 mL 2.6 mL 3.3 mL 4.2 mL 5.4 mL 6.6 mL 10 mL
Dextrose 10% IV IV IV IV IV IV IV IV IV IV 1 g 2 g 3 g 4 g 5 g 6.5 g 8 g 10.5 g 13.5 g 16.5 g 25 g
10 mL 20 mL 30 mL 40 mL 50 mL 65 mL 80 mL 105 mL 135 mL 165 mL 250 mL Dextrose 25% None IV IV IV IV IV IV IV IV IV
2.5 g 3.25 g 4.25 g 5 g 6.5 g 8.25 g 10.5 g 13.5 g 16.5 g 25 g 10 mL 13 mL 17 mL 20 mL 26 mL 33 mL 42 mL 54 mL 66 mL 100 mL
Dextrose 50% IV IV IV IV IV 25 g None None None None None 8.25 g 10.5 g 13.5 g 16.5 g 25 g
50 mL 16.5 mL 21 mL 27 mL 33 mL 50 mL
4102 — Calculation Chart (4/1/21 - 15:37) 11 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Diazepam IV IV IV IV IV IV IV IV IV IV 10 mg 0.2 mg 0.35 mg 0.45 mg 0.5 mg 0.5 mg 1 mg 1 mg 1.5 mg 1.5 mg 2.5 mg 2 mL 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.5 mL
Diazepam - IM IM IM IM IM IM IM IM IM IM IM 0.4 mg 0.65 mg 0.85 mg 1 mg 1.5 mg 1.5 mg 2 mg 2.5 mg 3.5 mg 5 mg 0.08 mL 0.13 mL 0.17 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 1 mL
Diazepam CPAP Related to CPAP Mask None None None None None None None None None 1 mg
0.2 mL Diazepam Autoinjector IM
10 mg None None None None None None None None None 10 mg 1 Autoinjector (AI) 1 AI Diphenhydramine IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM
50 mg 5 mg 5 mg 10 mg 10 mg 15 mg 15 mg 20 mg 25 mg 35 mg 50 mg 1 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 1 mL
DuoDote (NAAK) IM 2.1 mg / 600 mg None None None None None None None None None 2.1 / 600
1 Autoinjector (AI) 1 AI Epinephrine 1:1,000 IM IM IM IM IM IM IM IM IM IM
1 mg 30 mg 0.04 mg 0.07 mg 0.09 mg 0.1 mg 0.1 mg 0.2 mg 0.2 mg 0.3 mg 0.3 mg 0.3 mg 1 mL 30 mL 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.3 mL
Epinephrine 1:10,000 IV IV IV IV IV IV IV IV IV IV 1 mg 0.04 mg 0.07 mg 0.09 mg 0.1 mg 0.13 mg 0.17 mg 0.21 mg 0.27 mg 0.33 mg 1 mg
10 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.3 mL 10 mL Epinephrine 1:100,000 Push IV IV IV IV IV IV IV IV IV IV
0.01mg Dose 0.004 mg 0.007 mg 0.009 mg 0.01mg 0.01mg 0.01mg 0.01mg 0.01mg 0.01mg 0.01mg 1 mL Epi 0.4 mL 0.7 mL 0.9 mL 1 mL 1 mL 1 mL 1 mL 1 mL 1 mL 1 mL
Fentanyl IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 100 mcg 4 mcg 6.5 mcg 8.5 mcg 10 mcg 15 mcg 15 mcg 20 mcg 25 mcg 30 mcg 50 mcg
2 mL 0.08 mL 0.13 mL 0.17 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.6 mL 1 mL Fentanyl - IN IN IN IN IN IN IN IN IN IN x 2 IN
4 mcg 6.5 mcg 8.5 mcg 10 mcg 15 mcg 15 mcg 20 mcg 25 mcg 15 mcg 50 mcg 0.08 mL 0.13 mL 0.17 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.3 mL 1 mL
4102 — Calculation Chart (4/1/21 - 15:37) 12 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Glucagon IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 1 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 1 mg 1 mg 1 mg 1 mg 1 mg 1 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 1 mL 1 mL 1 mL 1 mL 1 mL
Glucose Gel PO PO PO PO PO PO PO PO PO PO 1 Tube 4 mL 7 mL 9 mL 10 mL 13 mL 1 Tube 1 Tube 1 Tube 1 Tube 1 Tube
Ipratropium Bromide NEB NEB NEB NEB NEB NEB NEB NEB NEB NEB 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL 2.5 mL
Ketamine IVPB
100 mg Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
0.3 mg/kg
1 mL +IVPB NS Ketamine IVPB
10 mg Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
0.3 mg/kg
1 mL +IVPB NS Ketamine - IN IN
50 mg 500 mg Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
Not permitted
0.5 mg/kg
1 mL 5 mL Lidocaine 2% IV IV IV IV IV IV IV IV IV IV
100 mg 400 mg 4 mg 6 mg 8 mg 10 mg 14 mg 16 mg 22 mg 28 mg 34 mg 100 mg 5 mL 20 mL 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 5 mL
Lidocaine Repeat IV IV IV IV IV IV IV IV IV IV 4 mg 6 mg 8 mg 10 mg 14 mg 16 mg 22 mg 28 mg 34 mg 50 mg
0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 2.5 mL Conscious IO Pain IO IO IO IO IO IO IO IO IO IO
2 mg 4 mg 4 mg 6 mg 8 mg 8 mg 12 mg 14 mg 18 mg 50 mg 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.4 mL 0.4 mL 0.6 mL 0.7 mL 0.9 mL 2.5 mL
4102 — Calculation Chart (4/1/21 - 15:37) 13 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Lorazepam IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN 4 mg 0.2 mg 0.2 mg 0.4 mg 0.4 mg 0.8 mg 0.8 mg 1.2 mg 1.2 mg 1.6 mg 2.4 mg 1 mL 0.05 mL 0.05 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.6 mL
Lorazepam - IM IM IM IM IM IM IM IM IM IM IM 0.4 mg 0.8 mg 0.8 mg 1.2 mg 1.2 mg 1.6 mg 2 mg 2.8 mg 3.2 mg 5.2 mg
0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.3 mL Lorazepam CPAP
Related to CPAP Mask None None None None None None None None None 1.2 mg 0.3 mL
Lorazepam IV IV IV IV IV IV IV IV IV IV 2 mg 0.2 mg 0.4 mg 0.4 mg 0.6 mg 0.6 mg 0.8 mg 1 mg 1.4 mg 1.6 mg 2.6 mg 1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.3 mL
Lorazepam - IM IM IM IM IM IM IM IM IM IM IM 0.4 mg 0.6 mg 0.8 mg 1 mg 1.4 mg 1.6 mg 2 mg 2.8 mg 3.4 mg 5 mg 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1 mL 1.4 mL 1.7 mL 2.5 mL
Lorazepam - IN IN IN IN IN IN IN IN IN x 2 IN x 2 IN x 2 0.2 mg 0.4 mg 0.4 mg 0.6 mg 0.6 mg 0.8 mg 1 mg 0.8 mg 0.8 mg 1.4 mg 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.4 mL 0.4 mL 0.7 mL
Lorazepam CPAP Related to CPAP Mask None None None None None None None None None 1 mg
0.5 mL Magnesium Sulfate IV IV IV IV IV IV IV IV IV IV
5 g 1 g 0.2 g 0.35 g 0.45 g 0.5 g 0.65 g 0.85 g 1.05 g 1.35 g 1.65 g 2 g 10 mL 2 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.3 mL 4 mL
Eclampsia IVPB In 50 mL over 10 min. None None None None None None None None None 5 g
10 mL Eclampsia IM IM x 2
None None None None None None None None None 2.5 g 5 mL
4102 — Calculation Chart (4/1/21 - 15:37) 14 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Magnesium Sulfate IV IV IV IV IV IV IV IV IV IV 4 g 0.2 g 0.36 g 0.44 g 0.52 g 0.64 g 0.84 g 1.04 g 1.36 g 1.64 g 2 g
100 mL (IV Bag) 5 mL 9 mL 11 mL 13 mL 16 mL 21 mL 26 mL 34 mL 41 mL 50 mL Eclampsia IVPB
In 50 mL over 10 min None None None None None None None None None 4 g 100 mL
Mark I (NAAK) IM 2 mg / 600 mg None None None None None None None None None 2 / 600
1 Autoinjector (AI) 1 Kit Midazolam IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN IV / IN
5 mg 10 mg 0.2 mg 0.35 mg 0.45 mg 0.5 mg 0.5 mg 1 mg 1 mg 1.5 mg 1.5 mg 2.5 mg 1 mL 2 mL 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.5 mL
Midazolam - IM IM IM IM IM IM IM IM IM IM IM 0.4 mg 0.7 mg 0.9 mg 1 mg 1 mg 2 mg 2 mg 3 mg 3 mg 5 mg 0.08 mL 0.14 mL 0.18 mL 0.2 mL 0.2 mL 0.4 mL 0.4 mL 0.6 mL 0.6 mL 1 mL
Anxiety s/p ROSC, CPAP BHO & hyperthermia induced
shivering None None None None None None None None None 1 mg
0.2 mL Midazolam IV IV IV IV IV IV IV IV IV IV
5 mg 0.2 mg 0.3 mg 0.4 mg 0.5 mg 0.7 mg 0.8 mg 1.1 mg 1.4 mg 1.7 mg 2.5 mg 5 mL 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 2.5 mL
Midazolam - IM IM IM IM IM IM IM IM IM X 2 IM X 2 IM X 2 0.4 mg 0.7 mg 0.9 mg 1 mg 1.3 mg 1.7 mg 2.1 mg 1.4 mg 1.7 mg 2.5 mg 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 1.4 mL 1.7 mL 2.5 mL
Midazolam - IN IN IN IN IN IN x 2 IN x 2 IN x 2 IN x 2 IN x 2 IN x 2 0.2 mg 0.3 mg 0.4 mg 0.5 mg 0.4 mg 0.4 mg 0.5 mg 0.5 mg 0.5 mg 1 mg 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.4 mL 0.4 mL 0.5 mL 0.5 mL 0.5 mL 1 mL
Anxiety s/p ROSC, CPAP BHO & hyperthermia induced
shivering None None None None None None None None None 1 mg
1 mL
4102 — Calculation Chart (4/1/21 - 15:37) 15 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Morphine Sulfate IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 10 mg 0.4 mg 0.7 mg 0.9 mg 1 mg 1 mg 2 mg 2 mg 3 mg 3 mg 5 mg 1 mL 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.5 mL
Morphine Sulfate IV IV IV IV IV IV IV IV IV IV 10 mg 0.4 mg 0.7 mg 0.9 mg 1 mg 1.3 mg 1.7 mg 2.1 mg 2.7 mg 3.3 mg 5 mg 10 mL 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3.3 mL 5 mL
Morphine Sulfate - IM IM IM IM IM IM IM IM IM x 2 IM x 2 IM x 2 0.4 mg 0.7 mg 0.9 mg 1 mg 1.3 mg 1.7 mg 2.1 mg 1.4 mg 1.7 mg 2.5 mg 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 1.4 mL 1.7 mL 2.5 mL
Naloxone IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 2 mg 0.4 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 2 mL 0.4 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL
Naloxone - IN IN x 2 IN IN IN IN IN IN IN IN IN 0.2 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 1 mg 0.2 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 1 mL
Naloxone IV IV IV IV IV IV IV IV IV IV 4 mg 0.4 mg 0.4 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg
10 mL 1 mL 1 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL Naloxone - IM IM IM IM IM IM IM IM IM IM IM
0.4 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 1 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL 1.25 mL
Naloxone - IN IN x 2 IN x 2 IN x 2 IN x 2 IN x 2 IN x 2 IN x 2 IN x 2 IN x 2 IN 0.2 mg 0.2 mg 0.2 mg 0.2 mg 0.2 mg 0.2 mg 0.2 mg 0.2 mg 0.2 mg 0.4 mg 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 0.5 mL 1 mL
Nitroglycerin SL 0.4 mg None None None None None None None None None 0.4 mg
1 tablet or Spray 1 tablet Nitro Paste 2% TD
1 g 30 or 60 g None None None None None None None None None 1 g
1 Inch 1 Tube 1 Inch Normal saline 0.9% IV IV IV IV IV IV IV IV IV IV
IV Solution 80 mL 130 mL 170 mL 200 mL 250 mL 250 mL 250 mL 250 mL 250 mL 250 mL 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus 1 Bolus
4102 — Calculation Chart (4/1/21 - 15:37) 16 of 18
Alternative Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Ondansetron IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM IV / IM 4 mg 40 mg 0.4 mg 0.6 mg 0.8 mg 1 mg 1.4 mg 1.6 mg 2.2 mg 2.8 mg 3.4 mg 4 mg 2 mL 20 mL 0.2 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 0.8 mL 1.1 mL 1.4 mL 1.7 mL 2 mL
Ondansetron ODT ODT ODT ODT ODT ODT ODT ODT ODT ODT ODT 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg 4 mg
1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet 1 tablet Pralidoxime IM IM IM IM IM IM IM IM IM IM
1000 mg 80 mg 140 mg 180 mg 200 mg 260 mg 340 mg 420 mg 540 mg 600 mg 600 mg 5 mL (in 20 mL Vial) 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3 mL 3 mL
IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB 1000 mg 80 mg 140 mg 180 mg 200 mg 260 mg 340 mg 420 mg 540 mg 600 mg 600 mg
20 mL 1.6 mL 2.8 mL 3.6 mL 4 mL 5.2 mL 6.8 mL 8.4 mL 10.8 mL 12 mL 12 mL Sodium Bicarb. 8.4% IV IV IV IV IV IV IV IV IV IV
50 mEq 10 mEq 4 mEq 6.5 mEq 8.5 mEq 10 mEq 13 mEq 16.5 mEq 21 mEq 27 mEq 33 mEq 50 mEq 50 mL 10 mL 4 mL 6.5 mL 8.5 mL 10 mL 13 mL 16.5 mL 21 mL 27 mL 33 mL 50 mL
Tranexamic acid IVPB 1 gram None None None None None None None None None 1 gram 10 mL 10 mL
4102 — Calculation Chart (4/1/21 - 15:37) 17 of 18
CDC Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Atropine (MDV) IM IM IM IM IM IM IM IM x 2 IM x 2 IM x 2 8 mg 0.2 mg 0.32 mg 0.44 mg 0.52 mg 0.64 mg 0.84 mg 1 mg 0.68 mg 0.84 mg 1 mg
20 mL 0.5 mL 0.8 mL 1.1 mL 1.3 mL 1.6 mL 2.1 mL 2.5 mL 1.7 mL 2.1 mL 2.5 mL Atropine (MDV) - IV IV IV IV IV IV IV IV IV IV IV
0.2 mg 0.32 mg 0.44 mg 0.52 mg 0.64 mg 0.84 mg 1.04 mg 1.36 mg 1.64 mg 2 mg 0.5 mL 0.8 mL 1.1 mL 1.3 mL 1.6 mL 2.1 mL 2.6 mL 3.4 mL 4.1 mL 5 mL
Atropine Autoinjector IM 2 mg None None None None None None None None None 2 mg
1 Autoinjector (AI) 1 AI Atropine Autoinjector IM IM IM IM IM
1 mg None None None None None 1 mg 1 mg 1 mg 1 mg 1 mg 1 Autoinjector (AI) 1 AI 1 AI 1 AI 1 AI 2 AI
Atropine Autoinjector IM IM IM IM IM IM IM IM IM IM 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg 0.5 mg
1 Autoinjector (AI) 1 AI 1 AI 1 AI 1 AI 1 AI 2 AI 2 AI 2 AI 2 AI 4 AI Diazepam IM IM IM IM IM IM IM IM IM IM
10 mg 0.4 mg 0.65 mg 0.85 mg 1 mg 1.5 mg 1.5 mg 2 mg 2.5 mg 3.5 mg 5 mg 2 mL 0.08 mL 0.13 mL 0.17 mL 0.2 mL 0.3 mL 0.3 mL 0.4 mL 0.5 mL 0.7 mL 1 mL
Diazepam - IV IV IV IV IV IV IV IV IV IV IV 0.2 mg 0.35 mg 0.45 mg 0.5 mg 0.5 mg 1 mg 1 mg 1.5 mg 1.5 mg 2.5 mg 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.5 mL
Diazepam AI IM 10 mg None None None None None None None None None 10 mg
1 Autoinjector (AI) 1 AI DuoDote (NAAK) IM 2.1 mg / 600 mg None None None None None None None None None 2.1 / 600
1 Autoinjector (AI) 1 AI Mark I (NAAK) IM 2 mg / 600 mg None None None None None None None None None 2 / 600
1 Autoinjector (AI) 1 Kit
4102 — Calculation Chart (4/1/21 - 15:37) 18 of 18
CDC Medications Grey 3–5 kg
Pink 6-7 kg
Red 8-9 kg
Purple 10-11 kg
Yellow 12-14 kg
White 15-18 kg
Blue 19-23 kg
Orange 24-29 kg
Green 30-36 kg Adult
Midazolam (Seizalam) IV IV IV IV IV IV IV IV IV IV 5 mg 50 mg 0.2 mg 0.35 mg 0.45 mg 0.5 mg 0.5 mg 1 mg 1 mg 1.5 mg 1.5 mg 2.5 mg 1 mL 10 mL 0.04 mL 0.07 mL 0.09 mL 0.1 mL 0.1 mL 0.2 mL 0.2 mL 0.3 mL 0.3 mL 0.5 mL
Midazolam (Seizalam) IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN IM/IN 0.4 mg 0.7 mg 0.9 mg 1 mg 1 mg 2 mg 2 mg 3 mg 3 mg 5 mg
0.08 mL 0.14 mL 0.18 mL 0.2 mL 0.2 mL 0.4 mL 0.4 mL 0.6 mL 0.6 mL 1 mL Pralidoxime IM IM IM IM IM IM IM IM IM IM
1000 mg 80 mg 140 mg 180 mg 200 mg 260 mg 340 mg 420 mg 540 mg 600 mg 600 mg 5 mL (in 20 mL Vial) 0.4 mL 0.7 mL 0.9 mL 1 mL 1.3 mL 1.7 mL 2.1 mL 2.7 mL 3 mL 3 mL Pralidoxime IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB IVPB
1000 mg 80 mg 140 mg 180 mg 200 mg 260 mg 340 mg 420 mg 540 mg 600 mg 600 mg 20 mL 1.6 mL 2.8 mL 3.6 mL 4 mL 5.2 mL 6.8 mL 8.4 mL 10.8 mL 12 mL 12 mL