It always seems easy when we follow the protocol in the OT and Recovery room without exactly knowing the strengh of the medication. Nurses make our work easy many often. We just order to start dopamine or adrenaline at 2 or 4 ml/hr and increase or decrease according to response. The same reason make us uncomfortable to work in pediatric cardiac surgery if we work in adult surgery.
Lets be specific; what are the medicines we use in surgery and after surgery and their dosage range? Residents always have nightmare remembering the exact dosage. I am not an exception!
Adrenaline= 0.01-0.05 mcg/kg/min
NorAdrenaline= 0.01-0.5 mcg/kg/min
Vasopressin= 0.01-0.07 units/min
Dopamine= 2-20 mcg/kg/min
Dobutamine= 5-20 mcg/kg/min
Milrinine = 50 mcg bolus then 0.375-0.75 mcg/kg/min
We uses 50ml syringe pumps for infusion. Hence, required dose of drug diluted till 50ml; this is to remember.
Adr/NorAdr/Isoprenaline/Levosimendan dose=( Weight of the Patient*0.3). Hence 1cc/hr will be 0.1 mcg/kg/min
Dopamine/SNP/NTG/Milrinone/Midazolam/Atracurium dose = Weight of the Patient * 3. Hence 1cc/hr will be 1 mcg/kg/min.
Many paediatric people must have been following this guideline. Adult protocol is same but we go by nurses. To conclude, I can say, It works magic for everybody. You will definitely feel confident when you know.