Formula First 10 kg → 100 mL/kg/day Next 10 kg → 50 mL/kg/day Each kg beyond 20 → 20 mL/kg/day
Hourly = Daily ÷ 24

Reference Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823–832.

Formula Volume (mL) = Weight (kg) × Dose (mL/kg)

Reference APLS / PALS Guidelines. Standard isotonic crystalloid bolus is typically 10–20 mL/kg. Adjust based on clinical context.

Formula Estimated deficit (mL) = Weight (kg) × % dehydration × 10 First 24h deficit (mL) = Weight (kg) × min(%, 5) × 10 First 24h total = First 24h deficit + 24h Maintenance Starting rate = First 24h total ÷ 24

Reference Holliday-Segar for maintenance. The staged first-24-hour deficit approach follows Royal Children's Hospital Melbourne. Clinical Practice Guideline: Intravenous Fluids. Updated January 2026. Deficit percentages are age-dependent because infants carry a higher proportion of total body water: infants 5 / 10 / 15%, adolescents 3 / 5–6 / 7–9% (Merck Manual Professional Edition, Dehydration in Children). That source states that standard estimates for children between infancy and adolescence have not been established, so the 12-year switch between the two scales is a local display convention, not a guideline figure; below 12 years the infant / young-child scale is applied. Estimating dehydration by percentage is itself unreliable (RCH) — treat the figure as a starting point and reassess clinically. In most children no more than an estimated 5% deficit is included during the first 24 hours; larger deficits require staged replacement with reassessment. Resuscitation boluses and ongoing losses are handled separately and are not included in the displayed total. Oral or NG rehydration is preferred when appropriate.

Formula GIR (mg/kg/min) = Dextrose% × Rate (mL/hr) × 1000 ÷ (Weight (kg) × 60 × 100) Simplified: (D% × rate) ÷ (weight × 6)

Reference Rozance PJ, Hay WW. Hypoglycemia in newborn infants. Biol Neonate. 2006;90(2):74–86.

Standard neonatal & paediatric practice for glucose delivery rate monitoring during IV dextrose therapy.

Formula % Loss = ((Birth wt - Current wt) / Birth wt) × 100 Normal physiologic loss: up to 7–10% in first week.

Reference AAP Newborn Nursery Guidelines. Neonates typically regain birth weight by 10–14 days.

Formula Weeks premature = 40 - GA at birth Corrected age = Chronological age - weeks premature

Reference AAP Committee on Fetus and Newborn. Corrected age used for developmental assessment until 2–3 years in preterm infants (<37 weeks GA).

Method — AAP 2022 Uses the exact AAP 2022 Supplemental Table 1–4 numeric values for phototherapy and exchange transfusion thresholds, stratified by completed gestational age, completed postnatal hour, and additional neurotoxicity risk factors. Applies to infants ≥35 weeks GA, age 1–336 hours. Inputs: GA: 35, 36, 37, 38, 39, or ≥40 weeks Age: postnatal hours, 1–336 Risk: additional neurotoxicity risk factors yes/no Outputs: Phototherapy threshold Escalation threshold = exchange threshold − 2 mg/dL Exchange transfusion threshold Important: Use total serum bilirubin (TSB). Do not subtract direct/conjugated bilirubin. Infants <24h at/above threshold need urgent hemolysis evaluation.

Reference Kemper AR, Newman TB, Slaughter JL, et al. Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 2022;150(3):e2022058859.

Replaces: AAP 2004 guideline (Pediatrics 2004;114:297-316).

References WHO Child Growth Standards: Weight-for-length/height: methods and development, 2006; official LMS z-score tables for weight-for-length, birth–2 years (45–110 cm), and weight-for-height, 2–5 years (65–120 cm), downloaded from WHO 12 Sep 2026. Recumbent length and standing height use different WHO tables; values outside a table's measurement range are not extrapolated.

CDC Growth Charts (2–20 years): Kuczmarski RJ et al. 2000 CDC Growth Charts for the United States: Methods and Development. Vital Health Stat 11(246), 2002. CDC Growth Chart Training, Anthropometric Indices and Using WHO Growth Standard Charts, reviewed 16 Jun 2024 (accessed 12 Sep 2026). Growth percentiles are screening/monitoring measures and are not diagnoses by themselves.

Saudi Growth Charts: Shaik SA, El Mouzan MI, Al Salloum AA, Al Herbish AS. Ann Saudi Med. 2016;36(1):2–6 (0–5y LMS parameters); El Mouzan MI et al. Ann Saudi Med. 2016;36(4):265–268 (5–18y LMS parameters for weight, height and BMI); El Mouzan MI et al. Saudi Med J. 2007;28(10):1555–1568 (fallback charts). Endorsed by the Saudi Council for Health Services.

Formulas Mosteller: sqrt(Ht x Wt / 3600) DuBois: 0.007184 x Ht^0.725 x Wt^0.425 Haycock: 0.024265 x Ht^0.3964 x Wt^0.5378

References Mosteller RD. Simplified calculation of body surface area. N Engl J Med. 1987;317(17):1098.

DuBois D, DuBois EF. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med. 1916;17(6):863–871.

Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area. J Pediatr. 1978;93(1):62–66.

How to use

Enter the child's age in years and months (either box may be blank; 2 weeks = 0.5 months). Three milestone cards appear:

• ● Current — always visible and highlighted. Milestones expected by the entered age.
• ✓ Already expected — tap to expand. Skills from the previous band that should already be mastered.
• → Developing now — tap to expand. Skills from the next band that are emerging.

Below the milestone cards, two red-flag cards are shown:

• 🚩 Age-specific red flags — from AAP Table 5 for the current age group.
• 🚩 Universal red flags — apply at any age, including loss of previously acquired skills.

Milestones are guides — normal development varies. For infants born preterm, use corrected age through approximately 24 months. The AAP recommends standardized developmental screening at 9, 18, and 30 months, and autism-specific screening at 18 and 24 months.

Reference Scharf RJ, Scharf GJ, Stroustrup A. Developmental Milestones. Pediatrics in Review. 2016;37(1):25–37 (Table 3, Developmental Milestones; Table 5, Developmental Red Flags).

Formula Uncuffed ID = (Age/4) + 4 Cuffed ID = (Age/4) + 3.5 Depth (cm) = (Age/2) + 12

Reference APLS / PALS Guidelines. Cole F. Pediatric formulas for the anesthesiologist. AMA J Dis Child. 1957. Use with clinical judgment; smaller tubes may be needed for anatomic variation.

Reference WHO Pocket Book of Hospital Care for Children, 2nd ed. (Equipment sizes by age/weight). Cross-check rule of thumb: NG/Foley (Fr) ≈ 2 × uncuffed ETT internal diameter (mm). Ranges extend WHO bands (to 7 y) with standard adolescent sizing; individualise to the child.

Reference Fleisher & Ludwig's Textbook of Pediatric Emergency Medicine, 7th ed. Roberts & Hedges' Clinical Procedures in Emergency Medicine & Acute Care, 7th ed.

Payne RB et al. Interpretation of serum total calcium. Ann Clin Biochem. 1979. Formula: Corrected Ca = Measured Ca + 0.02 × (40 − Albumin g/L). For ionised calcium, request a blood gas.

AG = Na⁺ − (Cl⁻ + HCO₃⁻). Normal 8–12 mmol/L. Albumin correction: AG + 2.5 × (4 − albumin g/dL). Delta ratio = (AG − 12) / (24 − HCO₃⁻). Emmett M, Narins RG. Medicine. 1977.

Conversion factors SI value = conventional × factor. Factors per AMA Manual of Style / IFCC SI conversion tables. Common pediatric analytes included; verify against your local laboratory's reported units and reference ranges.

Formula & interpretation FENa (%) = (UNa × SCr) ÷ (SNa × UCr) × 100. <1% suggests prerenal (sodium-avid); >2% suggests intrinsic renal injury/ATN; 1–2% indeterminate.

How well does the 1% threshold work? In adults, pooled sensitivity 90% and specificity 82% across 19 studies (1287 patients). It performs best in oliguric patients without CKD or diuretics (sensitivity 95%, specificity 91%) and worst on diuretics, where specificity falls to 54%. In children the evidence is weaker. In the only paediatric comparison (43 children with AKI), FENa <1% was present in just 44.4% of prerenal cases — no different from the intrinsic group — and mean FENa was 2% in prerenal versus 4.5% in intrinsic disease; the ROC-optimal paediatric cut-off was 1.6%. In that same cohort fractional excretion of urea <35% discriminated better than FENa <1%, though adult studies of FEUrea conflict, so treat it as an adjunct rather than a replacement.

Cautions: unreliable on diuretics, and in CKD, obstruction or acute glomerular disease. Neonates: tubular immaturity raises FENa physiologically, and we found no validated modern newborn cut-off — these bands should not be applied to neonates.

Sources: Abdelhafez M et al. Clin J Am Soc Nephrol. 2022;17(6):785–797 (systematic review and meta-analysis, adults). Fahimi D et al. Pediatr Nephrol. 2009;24(12):2409–2412 (paediatric FENa vs FEUrea). Steiner RW. Am J Med. 1984;77(4):699–702 (interpretation and the classic exceptions — note it does not itself define a 1–2% band).

Equations (both report mL/min/1.73 m²) Enter height in cm (and creatinine in mg/dL or µmol/L — tap the unit). The equations themselves use different height units, and the calculator converts for you:
• CKiD U25 (default): eGFR = k × (height[m] ÷ SCr[mg/dL]), with age- and sex-specific k — so a 120 cm child enters 120 and the equation uses 1.20 m.
• Bedside Schwartz: eGFR = 0.413 × (height[cm] ÷ SCr[mg/dL]). NIDDK prints the same equation as 41.3 × (height[m] ÷ SCr[mg/dL]); the two are identical (41.3 × m = 0.413 × cm).
Both assume steady-state serum creatinine from an IDMS / enzymatic-calibrated assay — unreliable in AKI or rapidly changing function (KDIGO lists non–steady-state conditions among the sources of error in creatinine-based GFR estimation). Validated in children & young adults: U25 in ages 1–25 y; Bedside Schwartz was derived in 349 children aged 1–16 y who had CKD (median measured GFR 41 mL/min/1.73 m²), and its authors note that further study in children with higher GFR is needed before using it to screen all children. Not for infants <1 y. KDIGO G-categories are most applicable to children >2 y (younger children have physiologically lower, maturing GFR). A G-category is not a diagnosis of CKD: KDIGO requires the abnormality to persist > 3 months, and G1–G2 additionally require a marker of kidney damage. Sources: Pierce CB et al. Kidney Int. 2021;99(4):948–956. Schwartz GJ et al. J Am Soc Nephrol. 2009;20(3):629–637. KDIGO 2024 CKD guideline (Kidney Int. 2024;105(4S):S117–S314) — CKD criteria and GFR categories, Tables 1–2, p. S137; non–steady-state conditions as a source of error in creatinine-based GFR estimation, §1.2.2, p. S176.

Formula CrCl (mL/min) = (urine creatinine × urine volume) ÷ (serum creatinine × collection time in minutes). Both creatinines in the same units cancel. BSA-indexed = CrCl × 1.73 ÷ BSA (Mosteller: √(ht·wt ÷ 3600)). Caution: timed-urine CrCl tends to overestimate true GFR because creatinine is also secreted by the renal tubules, but collection error — incomplete or over-collection and inaccurate timing — can push it in either direction (KDIGO 2024: mean bias 25% across 23 studies; supervise the collection where possible). Index to 1.73 m² before comparing against reference GFR ranges. Sources: Traynor J et al. How to measure renal function in clinical practice. BMJ. 2006;333(7571):733–737 (timed-collection clearance formula; tubular secretion causes overestimation). KDIGO 2024 CKD guideline (Kidney Int. 2024;105(4S):S117–S314), which supersedes the 2012 edition — creatinine clearance, Practice Point 1.2.2.8 and rationale, p. S183. BSA by Mosteller: Mosteller RD. N Engl J Med. 1987;317(17):1098.

Interpretation mg/mg — normal <0.2 (≥2 y) · <0.5 (6 months to <2 y); abnormal (non-nephrotic) 0.2 to <2; nephrotic-range ≥2.
mg/mmol (KDIGO’s printed SI bands) — normal <20 (≥2 y) · <50 (6 months to <2 y); abnormal 20 to <200; nephrotic-range ≥200.
1 mg/mg ≈ 113 mg/mmol, so the two sets of bands are the guideline’s rounded conventions rather than exact conversions of each other (0.2 mg/mg is 22.6, not 20). This calculator bands in the unit you enter: creatinine in mg/dL → the mg/mg cut-offs; creatinine in mmol/L (an SI lab) → KDIGO’s printed mg/mmol cut-offs. The other unit is printed alongside for reference. KDIGO itself notes its unit conversions are rounded (exact factor 0.113), so a ratio of 200–226 mg/mmol is nephrotic-range by the SI convention but not by the mass one.
Age is required before any band is shown. Under 6 months no band is given: newborn PCR is normally high (about 1–3 mg/mg, 100–300 mg/mmol, in the first days and weeks) and falls as the kidneys mature. KDIGO’s “6 months to 2 years” / “over 2 years” wording leaves the second birthday ambiguous; the stricter child cut-off applies from 24 months. A urine protein of 0 is reported as “no protein detected”.
Use a first-morning specimen — later/post-exercise samples overestimate (orthostatic proteinuria). Sources: KDIGO 2024 CKD guideline §1.3.1, p. S193 (paediatric normal cut-offs; neonatal values); KDIGO 2025 Nephrotic Syndrome in Children (nephrotic-range ≥200 mg/mmol = ≥2 g/g; conversions rounded, exact factor 0.113, p. S250); Hogg RJ et al. (PARADE). Pediatrics. 2000;105(6):1242–1249.

Classification (AAP 2017, Table 3) — AAP uses two different schemes by age. The 2018 erratum sets the younger band at 1 to <13 years. AGE 1 – <13 YEARS (percentile-based) Normal < 90th percentile Elevated ≥90th to <95th percentile, or 120/80 mmHg to <95th percentile (whichever is lower) Stage 1 HTN ≥95th to <95th percentile+12, or 130/80 to 139/89 mmHg (whichever is lower) Stage 2 HTN ≥95th percentile+12 mmHg, or ≥140/90 mmHg (whichever is lower) AGE ≥13 YEARS (fixed thresholds — not percentiles) Normal < 120/<80 mmHg Elevated 120/<80 to 129/<80 mmHg Stage 1 HTN 130/80 to 139/89 mmHg Stage 2 HTN ≥140/90 mmHg For age ≥13 the thresholds above are fixed decision values, not that patient’s percentiles — the percentile rows in the result are shown for reference only. Normative values come from AAP Table 4 (boys) and Table 5 (girls); the categories above are Table 3 verbatim.

Follow-up and referral — the result card’s next-step advice is AAP Table 11 (“Patient Evaluation and Management According to BP Level”). Lifestyle counselling is recommended in every category, normal included. Table 11 footnote d: if the patient is symptomatic, or BP is >30 mmHg above the 95th percentile (or >180/120 mmHg in an adolescent), send to an ED. This calculator takes no symptom input, so it flags the numeric limb and prompts you on the symptomatic one.

Height column — the child’s measured height is matched to the measured-height (cm) row that AAP prints above each age in Tables 4 and 5, interpolating linearly between columns (AAP labels the columns “Height Percentile or Measured Height”). Those printed heights are the heights of children in the middle of each age year, so a growth-chart percentile taken at the start of the year would read an average child as tall and pick higher thresholds. Heights below the 5th- or above the 95th-percentile column use that end column.

Reference Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017;140(3):e20171904.

Calculation

Severity — mild 130–134, moderate 120–129, severe < 120 mmol/L (UpToDate p. 2).

Corrected sodium — when glucose > 100 mg/dL: Na + 1.6 × (glucose mg/dL − 100) ÷ 100; glucose mmol/L × 18 = mg/dL (UpToDate p. 4). Above 11 mmol/L, DKA / HHS is asked first.

Maintenance — 4-2-1 rule (4 / 2 / 1 mL/kg/h), maximum 100 mL/h (RCH).

Severe neurological symptoms — 3% saline 3–5 mL/kg over 10–15 min, maximum 150 mL per bolus, up to two repeats; then 1–2 mL/kg/h if acute (UpToDate p. 11; NaCl drug information p. 10).

Mild / moderate symptoms — acute: senior-directed IV sodium chloride; chronic or unknown: no 3% saline (UpToDate pp. 12, 14–15).

Shock — glucose-free isotonic crystalloid 10 mL/kg over < 10 min (NICE NG29 §1.3.1).

Hypovolaemic — Na ≤ 130: 0.9% sodium chloride with 5% glucose at maintenance; Na 131–134: oral rehydration if tolerated (RCH).

Restriction — SIADH 60% of maintenance (UpToDate p. 12); oedematous 50–67% (RCH). Total intake across all routes.

Correction limit — chronic or unknown: aim 4–6, maximum 6–8 mmol/L per 24 h; acute: 6–8; acute symptomatic: < 8 including boluses (UpToDate pp. 10, 12, 15).

Monitoring — sodium hourly during emergency treatment (NICE NG29 §1.7.3); every 2–4 h while severe or symptomatic (UpToDate p. 13).

Above 70 kg — weight-based volumes are not calculated.

Limitations

Decision-support only — every rate or volume is a starting value, not a definitive prescription. No Adrogué–Madias or sodium-deficit formula is used. Weight-based maintenance may overestimate requirements in obesity or above the 91st centile. Not validated for neonates. Involve a senior, nephrology and endocrinology/PICU as appropriate.

Entry checks — sodium 90–200 mmol/L, weight 1–300 kg, automatic rates only up to 70 kg, an age question below 7 kg, a DKA / HHS question above glucose 11 mmol/L, and ongoing losses flagged at ≥ 500 mL/h or ≥ 10 mL/kg/h. These are this app's own safety prompts, not guideline reference ranges.

References

• Somers MJ, Traum AZ. Hyponatremia in children: Evaluation and management. UpToDate, topic last updated 9 April 2026 (literature review through August 2026), supplied PDF p. 2 (bands), p. 4 (glucose correction), pp. 9–13 (treatment and monitoring), pp. 14–15 (summary) — severity bands, emergency 3% regimen and continuing infusion, mild / moderate symptom guidance, correction targets, SIADH restriction and monitoring.
• Sodium chloride preparations (saline and oral salt tablets): Drug information. UpToDate (Lexicomp), supplied PDF p. 10 — maximum 150 mL per 3% bolus.
• Royal Children's Hospital Melbourne. Clinical Practice Guideline: Hyponatraemia (last updated November 2023) and its linked management flowchart — oedematous restriction range; fluid and starting rate in the hypovolaemic branch.
• Royal Children's Hospital Melbourne. Clinical Practice Guideline: Intravenous fluids (last updated January 2026) — maintenance table, 100 mL/h maximum.
• NICE NG29. Intravenous fluid therapy in children and young people in hospital (published December 2015, last updated June 2020; October 2022 amendment to the resuscitation bolus) — §1.3.1 shock bolus; §1.7.3 hourly sodium monitoring during emergency treatment.
Accessed September 2026.

Calculation

Severity — mild 146–149, moderate 150–169, severe ≥ 170 mmol/L; no automatic plan at ≥ 170 (RCH).

Maintenance — 4-2-1 rule (4 / 2 / 1 mL/kg/h), maximum 100 mL/h (RCH).

Deficit — % dehydration × weight (kg) × 10 = mL, replaced over 48 h (RCH).

Starting rate — maintenance + deficit ÷ 48 h, using 0.9% sodium chloride with 5% glucose. Not calculated above 70 kg.

Shock — glucose-free isotonic crystalloid 10 mL/kg over < 10 min.

Correction limit — sodium fall ≤ 0.5 mmol/L/h (≈ 10 mmol/L per 24 h) (UpToDate p. 13).

Potassium — none until urine output and renal function are confirmed (RCH).

Seizures during correction — consider cerebral venous sinus thrombosis or infarction; consider imaging with a contrast CT scan and discuss with ICU; hypertonic saline may slow a too-rapid fall (RCH).

Limitations

Decision-support only — every rate is a starting value, not a definitive prescription; no sodium fall is predicted from the fluid rate or the 48 h replacement period. Weight-based maintenance may overestimate requirements in obesity. Not validated for neonates.

Entry checks — sodium 90–200 mmol/L, weight 1–300 kg, automatic rates only up to 70 kg, an age question below 7 kg, dehydration 0–15%, and ongoing losses flagged at ≥ 500 mL/h or ≥ 10 mL/kg/h. These are this app's own safety prompts, not guideline reference ranges.

References

• Somers MJ, Traum AZ. Hypernatremia (elevated sodium) in children. UpToDate, topic last updated 9 March 2026 (literature review through August 2026), supplied PDF pp. 12–14 — free water deficit equations and the 0.5 mmol/L/h correction ceiling.
• Royal Children's Hospital Melbourne. Clinical Practice Guideline: Hypernatraemia (last updated October 2020) — severity bands, 48 h deficit replacement, initial fluid, monitoring.
• Royal Children's Hospital Melbourne. Clinical Practice Guideline: Intravenous fluids (last updated January 2026) — maintenance table, 100 mL/h maximum.
• NICE NG29. Intravenous fluid therapy in children and young people in hospital (published December 2015, last updated June 2020; October 2022 amendment to the resuscitation bolus) — §1.3.1 shock bolus.
Accessed September 2026.

Calculation

Severity — severe < 2.5, moderate 2.5–2.99, mild 3–3.49 mmol/L; normal 3.5–5 (topic p. 2, Table 1 p. 19).

Urgent IV — arrhythmia, marked weakness or paralysis, ECG changes, or K < 2.5 (topic p. 13).

Enteral KCl — 1–4 mmol/kg/day in 2–4 doses (Harriet Lane); single dose ≤ 2 mmol/kg, maximum 40 mmol; daily maximum 160 mmol (monograph pp. 3, 7).

IV KCl — 0.5–1 mmol/kg, maximum 40 mmol (Harriet Lane; monograph p. 3).

Rate — 0.5 mmol/kg/h, maximum 10 mmol/h; with arrhythmia up to 1 mmol/kg/h, maximum 20 mmol/h (Harriet Lane; monograph p. 19; topic p. 13).

Concentration — peripheral 80 mmol/L; central 0.4 mmol/mL, critical care only. Volume = mmol ÷ concentration (monograph p. 20).

Kidney impairment — IV dose reduced ≥ 50% (0.5 mmol/kg, maximum 20 mmol); enteral at the low end; IV contraindicated in kidney failure (monograph pp. 5, 11).

Redistribution — low end shown, because of rebound risk (monograph p. 6).

Recheck — potassium 1–2 h after an IV infusion, ≥ 2 h after an enteral dose (monograph p. 3).

Limitations

Decision-support only. Every dose and rate is a starting value to be checked against local policy and serial potassium. Potassium chloride only. Not for neonates aged 28 days or younger. Potassium in DKA is managed in the DKA pathway.

Entry checks — weight 1–150 kg and potassium 1–12 mmol/L. These are this app's own prompts, not guideline ranges.

References

• Somers MJ, Traum AZ. Hypokalemia in children. UpToDate, topic 97159 version 23.0, last updated 10 December 2025 (literature review through August 2026); supplied printout pp. 2, 7–9, 12–16 and 19.
• Potassium chloride: Pediatric drug information. UpToDate (Lexicomp), topic 13037 version 1250.0; supplied printout pp. 2–7, 11–13, 18–20 and 25.
• Hughes HK, Kahl LK, eds. The Harriet Lane Handbook: A Manual for Pediatric House Officers. 21st ed, international edition. Philadelphia: Elsevier; 2018. Formulary — potassium chloride for hypokalaemia: oral and IV dosing and maximum IV infusion rate.
Accessed September 2026.

Calculation

Definition — K > 5.5 mmol/L; up to 6.5 may be normal in young infants; severe ≥ 7 (p. 1).

Emergency — ECG conduction change, arrhythmia or marked weakness; K ≥ 7; or K 6–6.9 with rapid release. Peaked T waves alone do not count (pp. 2, 4). If the sample may be haemolysed and K is the only criterion, confirm first (pp. 3, 16–17).

Calcium gluconate 10% — 0.5 mL/kg, maximum 20 mL, over 5 min (p. 4).

Insulin + dextrose — insulin 0.1 units/kg, maximum 10, with 10% dextrose 5 mL/kg, maximum 250 mL, over 30 min (pp. 5–6).

Salbutamol, nebulised — < 25 kg 2.5 mg; 25–50 kg 5 mg; > 50 kg 10 mg; not with a pre-existing arrhythmia (p. 5).

Bicarbonate — metabolic acidosis only: 1 mmol/kg, maximum 50 mmol, over 10–15 min, as 8.4% 1 mL/kg or, under 6 months, 4.2% 2 mL/kg (p. 6).

Removal — furosemide 1 mg/kg, maximum 40 mg (p. 7); resin 1 g/kg, maximum 30 g (p. 8); dialysis if K stays > 6.5 or kidney dysfunction is severe (p. 9).

Non-emergency — acute: lower over 6–12 h; chronic below 7: no urgent lowering (pp. 2, 9–10).

Monitoring — potassium 1–2 h after starting; repeat emergency treatment if K stays ≥ 7 (p. 6).

Limitations

Decision-support only. Every dose is a starting value to be checked against local policy and serial potassium and glucose. Not for neonates aged 28 days or younger.

Entry checks — weight 1–150 kg and potassium 1–12 mmol/L. These are this app's own prompts, not guideline ranges.

References

• Somers MJ. Hyperkalemia in children: Management. UpToDate, topic 85908 version 32.0, last updated 29 May 2025 (literature review through August 2026); supplied printout pp. 1–10 and Table 1, pp. 16–19.
Accessed September 2026.

References
AAP / HealthyChildren.org infant formula feeding guidance. WHO Infant and Young Child Feeding principles. Australian Infant Feeding Guidelines (NHMRC 2012). Royal Children's Hospital Melbourne neonatal fluid and feed guidelines. NICE faltering growth guideline NG75.

Interpretation ≥ 10 Suggestive of cow's-milk-related symptoms — elimination diet (2–4 wk) + challenge 7–9 Below the ≥ 10 cut-off — not clearly suggestive ≤ 6 CMA unlikely CoMiSS 2022 update (Vandenplas et al): the cut-off was lowered from ≥ 12 to ≥ 10, and a score ≤ 6 predicts the absence of CMA. CoMiSS is an awareness / monitoring tool, not a diagnostic test — a score ≥ 10 warrants a 2–4 week cow's-milk elimination diet followed by an oral food challenge to confirm. Preferred age ≤ 6 months (extendable to 12 months). Additional pointers: worsening of existing eczema may indicate CMA; urticaria / angioedema occurring directly after milk in the absence of other food is strongly suggestive of CMA. Can also track symptom evolution during a milk-free trial.

Reference Vandenplas Y, Bajerova K, Dupont C, et al. The Cow's Milk Related Symptom Score: The 2022 Update. Nutrients. 2022;14(13):2682 — Table 4 (updated CoMiSS), implemented here. Original tool: Vandenplas Y, et al. Acta Paediatr. 2015;104(4):334–339.

Interpretation <12.5 Remission 12.5–<40 Mild activity 40–57.5 Moderate activity >57.5 Severe activity Response: ≥17.5-point decrease. Remission: score <12.5.

Reference Turner D, Griffiths AM, Walters TD, et al. Mathematical weighting of the pediatric Crohn's disease activity index (PCDAI) and comparison with its other short versions. Inflamm Bowel Dis. 2012;18(1):55–62. PMID: 21351206

Interpretation <10 Remission 10–34 Mild activity 35–64 Moderate activity ≥65 Severe activity Response to therapy defined as ≥20-point decrease. Remission <10. Acute severe UC ≥65.

Reference Turner D, Otley AR, Mack D, et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index. Gastroenterology. 2007;133(2):423–432.

Sources Heart rate & respiratory rate per PALS (AHA Pediatric Advanced Life Support), from Fleming S et al. Lancet. 2011;377:1011–1018. Hypotension = 5th-percentile systolic BP per PALS: <60 mmHg (term neonate), <70 mmHg (1–12 mo), <70 + 2×age (1–10 yr), <90 mmHg (>10 yr). Newborn RR per NRP. Ranges are for a resting child — interpret alongside fever, distress and trend. For formal BP classification use the BP Classifier (Nephrology).

Bazett Formula RR (sec) = 60 / HR QTc = QT (sec) / √RR QTc prolonged — children 1–15 y: >460 ms (borderline 440–460) · adolescents/adults: ♂ ≥450 ms · ♀ ≥460 ms (AHA/ACCF/HRS 2009). Consider drug effects, electrolyte disturbances, channelopathies.

Reference Bazett HC. An analysis of the time-relations of electrocardiograms. Heart. 1920;7:353–370.

Schwartz PJ et al. Diagnostic criteria for the long QT syndrome. Circulation. 1993;88:782–784.

Rautaharju PM et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the ECG, part IV (QT interval). Circulation. 2009;119:e241–e250. Children 1–15 y: QTc >440 ms borderline, >460 ms prolonged; adolescents/adults use sex-specific cut-offs (♂ ≥450, ♀ ≥460 ms).