Pharmacology
Weight-Based Paramedic Pharmacology
Calculating mg/kg doses for pediatrics and adults using FDA labeling concentrations and protocol maximums.
Calculation discipline
Paramedic dosing errors cluster around unit confusion—milligrams per kilogram versus total milligrams, and milliliters of concentrated epinephrine versus milligrams delivered. FDA-approved labels on DailyMed specify concentration, route, and usual dose ranges EMS protocols adapt.1 Always write: weight × mg/kg = total mg; then total mg ÷ concentration mg/mL = mL to administer.
Broselow tape or length-based systems estimate weight when children cannot be weighed—know when your protocol mandates actual weight for specific drugs. Round per protocol rules; never exceed single-dose or cumulative maximums even when math yields higher numbers.
High-risk medication classes
Epinephrine, amiodarone, adenosine, fentanyl, ketamine, rocuronium, and pediatric fluid boluses appear frequently in calculation drills.2 Double-check route: IM anaphylaxis epinephrine concentration differs from IV cardiac arrest epinephrine. Intranasal and intramuscular routes have different volume limits.
Document calculated dose, concentration used, volume drawn, and waste policy compliance. Medical direction may order off-protocol doses—record physician name, order, and repeat calculation with a partner for high-alert medications when policy requires.
Practice this skill
Apply what you read with a hands-on Pharmacology Mastery drill — instant feedback on every scenario.
