Inotropic support should only be provided after adequate fluid resuscitation
Where possible use a large vein or central line for these agents to decrease the likelihood of extravasation
Rule of 6's is a system in which the amount of drug in mg mixed in 100 mL final volume = Weight in Kg x 0.6
This system provides an easy method to infuse solutions, where 1 mL/hr = 0.1 mcg/kg/min
As an example, in a 10 kg child, 6 mg of drug would be mixed in 100 mL final volume (e.g. withdraw fluid from the 100 mL bag of fluid equal to the volume that 6 mg of drug will replace to make final volume = 100 mL) and to have 0.5 mcg/kg/min, the rate would equal 5 mL/hr
The usual range of dosing for Epinephrine is 0.1-2 mcg/kg/min
Beyond a patient weight of about 25 kgs, the concentration of the drug may exceed maximum recommended levels for infusion and standard concentrations rather than rule of 6's mixtures may be indicated
