Dosages of the common medications:

  1. Tamiflu (oseltamivir) dosing for children is based on age and weight. Here are the general dosing recommendations for both treatment and prophylaxis:

Tamiflu Treatment Dosage (for influenza)

  1. Infants < 1 year:

    • 3 mg/kg/dose twice daily.

  2. Children ≥ 1 year:

    • ≤ 15 kg: 30 mg twice a day.

    • > 15 to 23 kg: 45 mg twice a day.

    • > 23 to 40 kg: 60 mg twice a day.

    • > 40 kg: 75 mg twice a day.

    Duration: 5 days.

Tamiflu Prophylaxis Dosage

  1. Children < 3 months: Not recommended unless in critical situations.

  2. Children 3 months to < 1 year:

    • 3 mg/kg/dose once daily.

  3. Children ≥ 1 year:

    • ≤ 15 kg: 30 mg once daily.

    • 15 to 23 kg: 45 mg once daily.

    • 23 to 40 kg: 60 mg once daily.

    • > 40 kg: 75 mg once daily.

    Duration: 7 days after last known exposure.

Calculating IV fluids for pediatric patients involves determining maintenance requirements, deficit replacement, and accounting for ongoing losses. Here’s a step-by-step guide:

1. Maintenance Fluids

Use the Holliday-Segar Formula to calculate daily maintenance fluid requirements based on the child’s weight:

Body WeightFluid RequirementFirst 10 kg100 mL/kg/dayNext 10 kg50 mL/kg/day>20 kg20 mL/kg/day

For hourly rate: Divide the total by 24.

Example:
A 15 kg child:

  • First 10 kg: 10×100=1000 mL/day10×100=1000mL/day

  • Next 5 kg: 5×50=250 mL/day5×50=250mL/day

  • Total: 1000+250=1250 mL/day1000+250=1250mL/day or 125024=52 mL/hr241250​=52mL/hr.

2. Deficit Replacement

To replace dehydration, estimate the fluid deficit based on the degree of dehydration:

  • Mild (3–5%): 30–50 mL/kg

  • Moderate (6–9%): 60–90 mL/kg

  • Severe (≥10%): 100+ mL/kg

Deficit Calculation:

  • Deficit Volume=Weight (kg)×%dehydration×10Deficit Volume=Weight (kg)×%dehydration×10.

Replace the deficit over 24–48 hours (e.g., 50% in the first 8 hours, then the rest in 16–24 hours).

Example:
A 15 kg child with 6% dehydration:
15×0.06×10=900 mL15×0.06×10=900mL.

3. Ongoing Losses

Account for ongoing losses (e.g., diarrhea, vomiting):

  • Replace estimated losses mL for mL using ORS or IV fluids.

4. Total Fluid Requirement

The total fluid rate combines:

  1. Maintenance fluids.

  2. Deficit replacement.

  3. Ongoing losses.

5. Type of Fluid

  • Maintenance: Use isotonic fluids (e.g., 0.9% saline + 5% dextrose or Ringer's lactate with dextrose).

  • Deficit/Ongoing losses: Use isotonic fluids (e.g., 0.9% saline or Ringer's lactate).

Example Calculation

A 12 kg child with 5% dehydration, mild ongoing diarrhea (~200 mL/day):

  1. Maintenance:
    10×100+2×50=1100 mL/day10×100+2×50=1100mL/day.

  2. Deficit:
    12×0.05×10=600 mL12×0.05×10=600mL.

  3. Ongoing losses: ~200 mL.

Total in 24 hours:
1100+600+200=1900 mL/day1100+600+200=1900mL/day or 190024≈79 mL/hr241900​≈79mL/hr.

6. Monitoring

  • Reassess hydration status frequently.

  • Monitor urine output (1–2 mL/kg/hour is normal).

  • Check electrolytes to avoid complications like hypernatremia or hyponatremia.