Pediatric Anesthesia Quick Reference · Test version

Airway

Calculated + age/weight lookup

AUTO

ETT size

Primary estimate + backups

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ETT depth at lip / teeth

Use as starting estimate; verify position clinically

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Weight-guide cross-check

CHBC pediatric invasive ventilation guide

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Weight-banded cuffed ETT and depth guide from Child Health BC. If age- and weight-based estimates differ, use clinical judgment and have adjacent sizes available.

LMA size

Teleflex LMA weight band

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≤5 kg → #1; 5–10 → #1.5; 10–20 → #2; 20–30 → #2.5; 30–50 → #3; 50–70 → #4; 70–100 → #5; >100 → #6.

Laryngoscope blade

Recommendation, not a mathematical formula

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Straight blades are commonly preferred in neonates/infants; curved blades are commonly used in older children. Exact blade choice depends on anatomy, video-laryngoscope system and operator preference.

Ventilation

Initial reference settings

REFERENCE

Tidal volume

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mL • calculated from weight

Enter age and weight for ventilation references.

Initial RR

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breaths/min · approximate start

Inspiratory time

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seconds

PEEP

5–8

cm H₂O, initial reference

For ventilator tidal volume, use the lesser of predicted/ideal body weight and actual body weight when applicable. Adjust to gas exchange, mechanics and surgical context.

Vascular Access

Age/weight-based preparation guide

LOOKUP

These are preparation references, not automatic device orders. For arterial/CVC placement, ultrasound vessel diameter and the clinical indication take priority over age or weight alone.

Peripheral IV

Typical catheter sizes to have available

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Radial arterial catheter

Confirm artery diameter with ultrasound when feasible

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Non-tunneled CVC

French size reference; vessel-to-catheter ratio matters

—

Intraosseous access

Emergency reference; device/manufacturer dependent

—

Fluids & Blood

Weight-based calculations

AUTO

Maintenance fluid

4-2-1 · cc/hr = mL/hr

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1 cc = 1 mL. The hourly rates are equivalent.

First 10 kg: 4 cc/kg/hr
Next 10 kg: 2 cc/kg/hr
Above 20 kg: 1 cc/kg/hr

18 kg: 10×4 + 8×2 = 56 cc/hr
35 kg: 10×4 + 10×2 + 15×1 = 75 cc/hr

This estimates basal maintenance needs, not a fixed intraoperative order. Choose isotonic fluid, consider a balanced crystalloid per local policy, and individualize for surgical losses, perfusion, urine output and comorbidities. Do not automatically replace a full fasting deficit. Neonates and young infants may need glucose support and monitoring. Fluid reference.

Fluid bolus shortcuts

Display only; indication determines actual bolus

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10 mL/kg = 10 × weight
20 mL/kg = 20 × weight

Estimated blood volume

Age-specific mL/kg range

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EBV = weight × blood volume (mL/kg)
Term newborn 80–90; infant <1 yr 75–80; child 1–12 yr 70–75 mL/kg. Prematurity requires separate assessment.

Maximum allowable blood loss

Requires initial + target Hct above

Enter Hct

MABL = EBV × (Hctᵢ − Hctₜ) / Hctᵢ. This is only one component of transfusion decision-making.

Awake / Resting Vital Signs

Age-specific reference ranges; not anesthetized targets

LOOKUP

Stanford reference values · HR / RR / SBP / DBP

Heart rate

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beats/min

Respiratory rate

—

breaths/min

SBP reference

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mmHg · systolic

DBP reference

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mmHg · diastolic

Stanford reference ranges · compare with the patient's baseline.

HR / RR / SBP / DBP by age

Adapted from the Stanford badge card (revised 2019). The PDF's final age label is incomplete; ≥16 yr follows the supplied age grouping. For automated lookup, 6 months starts the 6–<12 mo band and 12 months starts the 1–3 yr band. These are resting references, not anesthetic targets; consider sleep, anxiety, fever and baseline. Newborn day/week ranges cannot be chosen from whole months alone.

Hypotension threshold

PALS-style systolic threshold

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Oxygenation, CO₂, temperature & monitoring

SpO₂

Healthy child; individualize for disease and baseline

≥95%

EtCO₂

Typical reference; adjust for physiology and surgery

35–45 mmHg

Temperature

Stanford badge reference

36.5–38°C

Core temperature

General lower limit; newborn normothermia 36.5–37.5°C

≥36°C

Reassess oxygenation or ventilation changes promptly; consider airway/tube, ventilation, oxygen supply and circulation. Use age-appropriate warming, warmed fluids and temperature monitoring.

ASA: determine and evaluate HR/BP at least every 5 minutes, display ECG continuously, and monitor expired CO₂ continuously with an ETT/SGA as specified in the standard. Sources: ASA · EtCO₂ reference (children >3 yr) · Pediatric ventilation review · Temperature ranges.

Anesthesia Drugs

Calculated doses; clinical context matters

AUTO

Doses below auto-calculate from the entered weight. They are quick-reference values, not automatic orders. Titrate sedatives/hypnotics/opioids to effect; verify age restrictions, maximum doses, obesity weight scalar, organ dysfunction, interactions and local policy.

Cardiac / PALS

2025 AHA/AAP weight-based reference

AUTO

Emergency Rescue

Selected perioperative emergencies; verify local protocol

AUTO

Emergency calculations are quick references, not a substitute for the full crisis checklist. Use the actual measured weight when the cited emergency guideline specifies actual/true body weight.

Local Anesthetic

Max dose → concentration → volume

AUTO

Maximum-dose references are conservative aids, not targets. Reduce dose in neonates/young infants and when combining local anesthetics.

References used in this prototype

ANZCOR — Tracheal Intubation and Ventilation of the Newborn: neonatal uncuffed ETT size by weight and lip depth ≈ weight + 6 cm.
AAP/AAPD pediatric sedation guideline: reduce amide local-anesthetic maximum doses by 30% in infants <6 months.
RCH — Sedative Premedication Guidelines: dosing table, Midazolam oral 0.5 mg/kg (Max. 20 mg).
Royal Children's Hospital — Airway management: cuffed ETT formula, backups, oral depth formula.
Child Health BC — ETT Size and Depth / Initiation of Ventilation: pediatric ETT size ranges and ventilation settings.
Child Health BC — Pediatric Intubation Checklist: weight-banded ETT/depth, blade and suction guidance.
Teleflex — LMA Unique sizing: weight-based LMA sizes.
OpenAnesthesia — Pediatric Ventilation: Physiology.
OpenAnesthesia — Perioperative Fluid Administration in Children.
OpenAnesthesia — Maximum Allowable Blood Loss: estimated blood volume ranges.
Child Health BC — BC PEWS Pediatric Vital Signs.
AHA/AAP 2025 Pediatric Advanced Life Support: arrest/bradycardia/tachyarrhythmia doses and defibrillation energy.
Vascular access in children: pediatric non-tunneled CVC, arterial and IO size references.
Ultrasound vessel sizing before cannulation: pediatric radial artery diameter and catheter gauge considerations.
DailyMed — Glycopyrrolate Injection: pediatric intraoperative and preanesthetic dosing.
OpenAnesthesia — Nondepolarizing Neuromuscular Blocking Agents.
RCH — Premedication for Anaesthesia: midazolam / ketamine premedication.
OpenAnesthesia — PONV in Children: ondansetron.
RCH — Acute Pain Management: IV acetaminophen/paracetamol.
Fifth Consensus Guidelines for PONV (2026): main article Table 3 lists pediatric dexamethasone 0.15 mg/kg up to 4 mg; SDC3 Table 3 is on p.15 and SDC1 pediatric dexamethasone discussion on p.41.
DailyMed — Propofol Injection: pediatric induction labeling.
DailyMed — Ketamine Injection: IV and IM induction dosing.
DailyMed — Etomidate Injection: pediatric age limitation and induction dosing.
DailyMed — Midazolam Injection: age-specific pediatric IV sedation dosing.
DailyMed — Rocuronium: pediatric initial intubation and maintenance dosing.
DailyMed — Succinylcholine: pediatric IV/IM dosing.
DailyMed — Cisatracurium: age-specific pediatric intubation dosing.
DailyMed — Sugammadex: actual-body-weight reversal dosing and pediatric age indication.
DailyMed — Neostigmine: pediatric reversal dosing and maximum dose.
DailyMed — Ondansetron: pediatric postoperative nausea/vomiting dosing.
DailyMed — Acetaminophen Injection: neonatal, infant, child and adolescent dosing.
NYSORA — Pediatric local anesthetic maximum-dose table. Young infants require dose reduction and institutional confirmation.
ASRA — LAST Checklist (2020): 20% lipid bolus/infusion and maximum lipid dose 12 mL/kg. The 2017 ASRA advisory specifies ideal body weight for the <70-kg infusion calculation.
SPA Pedi Crisis Checklist — current PDF: Anaphylaxis card p.2 (epinephrine IV/IO 1–10 mcg/kg; IM 10 mcg/kg); Laryngospasm card p.16 (succinylcholine IM 2–4 mg/kg; atropine IV/IM).
ANZCOR Guideline 13.5, section 1.2: newborn ETT size by weight/gestation and lip depth ≈ weight + 6 cm, with corrected-gestation table.
MHAUS — Managing an MH Crisis: dantrolene 2.5 mg/kg initial dose and formulation details.
2023 Anaphylaxis Practice Parameter: IM epinephrine 0.01 mg/kg; pediatric/adolescent maximums depend on developmental category.
Society for Pediatric Anesthesia — Pedi Crisis checklists: laryngospasm rescue dosing.
NSW ACI — APLS guide weights: used only as a gross entry plausibility screen, not as a growth percentile or substitute for measured weight.