About this child

In pediatrics, what counts as “normal” depends on age and development — so we start here. These details stay on this device and are de-identified (no names or identifiers); they choose which screen applies and how each item is interpreted.

Reference aid only. This pediatric tool supports — and does not replace — clinical judgment, local protocol, and prescriber/pharmacy review. It is not a validated decision-support device or an order set. Pharmacologic content is off-label and limited-evidence; verify every weight-based dose against your institution's formulary.

Child context

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Chronological age

Baseline mental status

Weight (kg) — optional

Wears glasses / corrective lenses — have them in place Uses hearing aids / cochlear device — have them in place

Agent	Pediatric dose	Notes
Dexmedetomidine preferred	0.2–1 mcg/kg/hr IV infusion, titrated to a light goal; a loading bolus is often omitted in the PICU to limit hemodynamic effects.	Delirium-sparing — preferred over benzodiazepines. Bradycardia, hypotension (biphasic BP); caution in cardiac disease / AV block. Rebound agitation/hypertension if stopped abruptly after prolonged use — taper. Not a substitute for analgesia (opioid-sparing at most) or reliable amnesia. PICU continuous sedation is off-label; the only FDA-labeled pediatric use is procedural sedation of non-intubated children ≥ 1 month.
Benzodiazepines (midazolam, lorazepam)	Limit / avoid as continuous sedation.	Independent, dose-related delirium risk. Do not escalate to treat delirium-related agitation. Reserve for specific indications (status epilepticus, sedative / alcohol withdrawal, procedural need).
Melatonin	0.5–3 mg PO at bedtime (younger); up to 3–5 mg (older children / adolescents) — general pediatric sleep dosing.	Sleep / circadian support — not a delirium treatment. Limited pediatric ICU evidence (delirium-prevention data are adult-ICU only). Confirm product (immediate- vs extended-release).

Agent	Pediatric dose (enteral unless noted)	Notes
Risperidone	Start low and titrate, by age / weight band. ≤ 2 yr ~0.01–0.04 mg/kg/day (mean ~0.02) — studied only in a 17-patient cohort; verify every dose with a pediatric pharmacist. < 5 yr ~0.1 mg q12–24h; ≥ 5 yr ~0.2 mg q12–24h. No single daily maximum spans infants to adolescents — set the ceiling from a named institutional protocol or formulary for the child's age and weight.	Often first-line oral. QTc (least among atypicals — still monitor), EPS / dystonia, hyperprolactinemia, sedation, metabolic. Baseline + follow-up ECG.
Quetiapine	~0.43–0.7 mg/kg/dose q8h (initiation ≈ 1.5 mg/kg/day divided q8h; reported median 1.3 mg/kg/day, IQR 0.4–2.3).	Sedating (useful at night); often chosen in the cardiac ICU. QTc prolongation reported; orthostasis, metabolic. Baseline + follow-up ECG.
Olanzapine	Age-banded start: infants ~0.625 mg; toddlers ~1.25 mg; older / severely agitated ~2.5–5 mg, once–twice daily. ODT useful if swallowing is difficult.	Prominent sedation and metabolic / weight gain; anticholinergic effects; QTc.
Haloperidol reserve	Reserve for severe agitation when an enteral antipsychotic isn't feasible. IV is off-label; use it only under a current institutional pediatric agitation / delirium protocol. That protocol must specify age- and weight-based eligibility, route, the repeat interval, a maximum cumulative loading dose and a maximum daily dose, ECG / electrolyte monitoring, contraindications, and the treatment of acute dystonia. No generic loading or maintenance dose is shown here — the published pediatric data are a few small case series whose loading totals and intervals differ several-fold, so a numeric range without those protocol bounds would be unsafe. Oral liquid available.	High caution. Dose-dependent QTc prolongation / torsades — continuous ECG, correct K / Mg; IV use carries an FDA torsades warning. More EPS / acute dystonia than atypicals in children (have IV diphenhydramine / benztropine ready). NMS; lowers seizure threshold. Avoid in long-QT, significant hepatic impairment, Parkinsonism.