PaedsCalc

Quick Prescriptions

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Clinical Engines:

Patient Weight (kg)

⚖ kg

Medication

💊

Formulation / Concentration

▱

Clinical Regimen / Indication

▣

🫁 Pediatric Asthma Clinical Suite (GINA & MoH)

Point-of-care clinical tools to evaluate chronic symptom control and triage acute pediatric wheezing attacks.

Evaluate pediatric asthma control in the past 4 weeks (GINA Guidelines):

☀️ 1. Daytime Symptoms (>2 times / week)

🌙 2. Any Night Waking Due to Asthma Cough / Wheeze

💨 3. SABA / Reliever Needed (>2 times / week)

🏃 4. Any Activity Limitation Due to Asthma (Play / Sports)

✓ Well-Controlled Asthma (Score: 0/4) GINA Pediatric Tier

Patient demonstrates good asthma control. Maintain current controller regimen. Reassess in 3–6 months.

Clinical severity staging for acute pediatric wheezing/bronchospasm (MoH Paediatric Protocols):

🗣️ 1. Ability to Talk / Cry

🫁 2. Chest Retractions & Accessory Muscle Use

📊 3. Oxygen Saturation (SpO₂ on Room Air)

🟢 Mild Acute Exacerbation Interactive MoH Triage

• Salbutamol MDI: 4–6 puffs via Valved Holding Chamber (Spacer) (or Nebulized Salbutamol 2.5mg <5y / 5mg ≥5y).
• Assessment: Re-evaluate in 15–30 minutes.
• If symptoms resolve, continue SABA Q4H PRN. Review inhaler technique and asthma action plan.

🟢 Mild Acute Exacerbation (MoH Triage)

MoH CPG Protocol

Clinical Presentation: Normal mental status, speaks in sentences, mild chest indrawing, tachypneic, SpO₂ ≥ 95% on room air.

• Inhaled SABA: Salbutamol MDI via Valved Holding Chamber (Spacer) 4–6 puffs (1 puff every 30–60s) OR Salbutamol Nebuliser 2.5 mg (<5 yrs) / 5 mg (≥5 yrs).

• Assessment: Re-evaluate post 15–30 minutes. If stable with good air entry, discharge with spacer technique reinforcement and asthma action plan.

⚠️ Moderate Acute Exacerbation (MoH Triage)

MoH CPG Protocol

Clinical Presentation: Speaks in phrases/partial sentences, moderate subcostal/intercostal recessions, tracheal tug, SpO₂ 92–94% on room air.

• Nebulizer: Salbutamol Nebuliser Solution 2.5 mg (<5 yrs) or 5 mg (≥5 yrs) every 20–30 min (up to 3 doses).

• Systemic Steroids: Oral Prednisolone 1–2 mg/kg/day BD for 3–5 days (Max adult ceiling 40 mg/day).

• Re-evaluation: Re-assess after 30–60 min. If poor response, escalate to Ipratropium and arrange admission.

🚨 Severe / Impending Respiratory Arrest (MoH Triage)

Red Zone / Resus

Clinical Presentation: Unable to speak/cry, drowsy/confused, exhausted, marked subcostal/sternal retractions, cyanosis, "silent chest", SpO₂ < 92% on room air.

• Oxygen: High-flow oxygen via non-rebreather mask (10–15 L/min) to maintain SpO₂ > 94%.

• Combined Nebulisation: Salbutamol Nebuliser (2.5 mg or 5 mg) + Ipratropium Bromide (250 mcg <12y / 500 mcg ≥12y) or Combivent UDV via oxygen 6–8 L/min Q20min × 3 doses.

• Parenteral Steroids: IV Hydrocortisone (Solu-Cortef) 4 mg/kg STAT (Max 100 mg).

• Emergency Escalation: Arrange immediate ambulance transfer / Red Zone resuscitation.

⚖

Active Patient Weight: (Enter in Dosing tab)

Anaphylaxis: IM Adrenaline (1:1,000)

IM ONLY

0.01 mg/kg (= 0.01 mL/kg of 1 mg/mL)

-- mL (-- mg)

Dose cap: 0.5 mL (≥50kg/Adults) • 0.3 mL (Children <30kg)

💉 Draw with 1 mL syringe. Strictly IM anterolateral thigh. Never IV bolus.

Seizure: Rectal Diazepam

RECTAL

0.5 mg/kg (Max: 10 mg)

Packaging: <3y (<12kg): 5 mg tube | ≥3y (≥12kg): 10 mg tube

⚡ Buccal Midazolam: 0.2–0.3 mg/kg (Max 10 mg) | IV Diazepam: 0.2–0.3 mg/kg (Max 10 mg)

Shock: Normal Saline 0.9% Bolus

IV PUSH

20 mL/kg (10 mL/kg in DHF/Cardiac/Renal)

-- mL

⚠️ DHF / Cardiac: -- mL (10 mL/kg)

Push over 5–10 mins. Max 1,000 mL/bolus.

🩺 Re-evaluate HR, CRT, BP, liver edge, and lung sounds after every bolus.

Hypoglycaemia: Dextrose 10% IV

IV STAT

5 mL/kg (0.5 g/kg glucose - Rule of 50)

-- mL

Max stat bolus: 250 mL of D10% (25 g glucose).

🩸 Alternative: D25% 2 mL/kg (dilute 1:1). Recheck glucose in 15–30 mins.

IV Hydrocortisone (Solu-Cortef)

Acute Severe Asthma Anaphylaxis

4 mg/kg (Max: 100 mg stat)

Calculated Dose -- mg

Volume from Vial -- mL Concentration: 50 mg/mL

Diluent to Add (NS 0.9%) -- mL Total volume: 10 mL

Reconstitute Powder

Inject 2.0 mL Sterile Water into 100 mg vial. Mix gently to yield 50 mg/mL.

➜

Draw & Dilute (Isotonic)

Draw -- mL. Top up with -- mL Normal Saline 0.9% into a 10 mL syringe.

➜

Slow IV Push

Push slowly over 3 to 5 minutes.
Never rapid bolus or infuse with plain water.

Pediatric Growth & Weight Estimator (WHO Reference)

Estimation Standard

WHO / MoH Standard: Formula Age × 2 + 8 for 1–5 yrs, WHO Growth Standard medians for >5 yrs.

Patient Age

Height (cm) (Optional: IBW >5y)

WHO Average Weight Reference Chart (MoH Standard)

Age	Boys (Median)	Girls (Median)	Formula / Guide
1 Month	4.5 kg	4.2 kg	(Months × 0.5) + 4
6 Months	7.9 kg	7.3 kg	(Months × 0.5) + 4
1 Year	9.6 kg	8.9 kg	Age × 2 + 8
2 Years	12.2 kg	11.5 kg	Age × 2 + 8
3 Years	14.3 kg	13.9 kg	Age × 2 + 8
4 Years	16.3 kg	16.1 kg	Age × 2 + 8
5 Years	18.3 kg	18.2 kg	Age × 2 + 8
6 Years	20.5 kg	20.2 kg	WHO Growth Standard
7 Years	23.1 kg	22.8 kg	WHO Growth Standard
8 Years	25.6 kg	25.6 kg	WHO Growth Standard
10 Years	31.9 kg	32.5 kg	WHO Growth Standard
12 Years	39.8 kg	41.5 kg	WHO Growth Standard

Estimate expected pediatric age range from weight using WHO percentile tables.

Patient Weight (kg)

Weight to Approximate Age Mapping

Weight Band	Estimated Age	Standard Development Stage
3.0 – 5.0 kg	0 – 2 Months	Early Neonatal / Infant
5.1 – 7.5 kg	2 – 6 Months	Young Infant
7.6 – 9.5 kg	6 – 12 Months	Older Infant
9.6 – 12.5 kg	1 – 2 Years	Toddler
12.6 – 15.0 kg	2 – 3.5 Years	Early Preschool
15.1 – 18.5 kg	3.5 – 5 Years	Preschool
18.6 – 23.0 kg	5 – 7 Years	Early Primary
23.1 – 28.0 kg	7 – 9 Years	Primary School
28.1 – 35.0 kg	9 – 11 Years	Late Primary
35.1 – 45.0 kg	11 – 13 Years	Early Adolescent
> 45.0 kg	> 13 Years	Adolescent / Adult Dosing

🟡 MoH Neonatal Jaundice (NNJ) Nomogram

CPG 2014 2nd Ed

Malaysian MoH clinical risk stratification (0–168 Hours / Day 1–7) with dynamic cutoff curves.

Total Serum Bilirubin (TSB)

µmol/L

Gestational Age Category

Infant Chronological Age / Hours of Life

hours

MoH Neurotoxicity Risk Factors (Shifts to Higher Risk Curve)

Hemolytic Disease (ABO Incompatibility, Rh Isoimmunization, positive Coombs test) G6PD Deficiency Clinical Instability (Sepsis, Asphyxia, Significant Lethargy, Hypothermia, Serum Albumin <3.0 g/dL)

Enter age in hours and TSB level to compute risk assessment.

🦟 MoH Pediatric Dengue Fluid Management

MoH CPG 3rd Ed

24-Hour fluid quota & stepped titration rates for critical phase plasma leakage.

Patient Weight (kg)

Clinical Phase & Dehydration Tier

24h Maintenance (M)

-- mL/day

-- mL/hr

Dehydration Deficit

-- mL

50 mL/kg for 5%

24h Total Fluid Quota

-- mL/day

M + Deficit (Strict Ceiling)

MoH Stepped Rate Titration Table Adjust hourly rate every 2–4 hours based on HCT & vitals

Titration Step	Rate Formula	Target Rate (mL/hr)	Clinical Indication
Step 1: M + 7%	(M + 70 mL/kg) / 24h	-- mL/hr	Severe plasma leakage / Rising HCT >20%
Step 2: M + 5%	(M + 50 mL/kg) / 24h	-- mL/hr	Initial rate for Warning Signs / Stable hemodynamics
Step 3: M + 3%	(M + 30 mL/kg) / 24h	-- mL/hr	Step-down when HCT stabilizes & urine >1 mL/kg/hr
Step 4: M (Maintenance)	Standard 4:2:1 Holliday-Segar	-- mL/hr	Leakage subsiding / Good peripheral perfusion
Step 5: ½ M (Recovery)	50% of Maintenance	-- mL/hr	Entering convalescent reabsorption phase; stop within 24–48h

⚠️ MoH Fluid Overload Warning: Do not exceed the 24-hour calculated quota ($M + 5\%$ or $M + 7\%$). If HCT continues to climb despite $M+7\%$, suspect active internal bleeding or refractory shock—obtain urgent senior paediatric consult for plasma/colloid or blood transfusion.

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🛡️ Clinical Governance & Safety Notice

For Registered Healthcare Professionals only. PaedsCalc serves as a point-of-care clinical calculation aid. Dosing parameters and formulation data are synthesized from authoritative pediatric guidelines. All computed doses must be independently verified against patient-specific clinical parameters, renal/hepatic function, and institutional protocols prior to drug administration.

📚 Malaysian MoH Paediatric Protocols 📖 MIMS Malaysia 📘 BNF for Children (BNFc) 📋 Frank Shann Drug Doses

Favorite Medications

🟢 Mild Acute Exacerbation (MoH Triage)

⚠️ Moderate Acute Exacerbation (MoH Triage)

🚨 Severe / Impending Respiratory Arrest (MoH Triage)

Anaphylaxis: IM Adrenaline (1:1,000)

Seizure: Rectal Diazepam

Shock: Normal Saline 0.9% Bolus

Hypoglycaemia: Dextrose 10% IV

IV Hydrocortisone (Solu-Cortef)

🟡 MoH Neonatal Jaundice (NNJ) Nomogram

💧 Pediatric Maintenance & Rehydration Fluids

🦟 MoH Pediatric Dengue Fluid Management

Install on iPhone / iPad