Paediatric & Neonatal Life Support (MPLS / NRP)
Doses need the weight; ETT size, ventilation rate and normal values need the age. Weight unknown? Estimate it with the weight estimation calculator — MPLS itself gives no formula.
Enter the weight.
Notes
Every dose is from the MPLS Provider Manual (2022). A maxtag means the weight-based dose went over the manual's maximum and the maximum is shown.
The manual gives two adenosine schedules. Its drug formulary says 0.1 mg/kg (max 6 mg), then 0.2 mg/kg (max 12 mg); its SVT algorithm says 100, 200 then 300 mcg/kg with a 12 mg maximum, and 400–500 mcg/kg after specialist advice. Both are shown; they differ only in the first-dose cap and the third dose.
Shock energy has no ceiling in the manual, nor does ETT adrenaline. In a large child the weight-based figure can exceed what the device or adult practice uses; select the nearest available setting.
Fluids: give smaller aliquots (5–10 mL/kg) in cardiogenic shock, raised intracranial pressure, DKA, renal or liver failure, trauma and neonates, and reassess after every bolus. Never use dextrose-containing fluid for resuscitation except to treat hypoglycaemia.
Related: status epilepticus, acute asthma, maintenance fluid.
Enter the weight for doses and tube sizes; gestation sets the starting oxygen.
Target pre-ductal SpO₂ after birth
0:00
Oximeter on the right hand or wrist. These targets apply to newly born babies; an ill baby outside the newborn period starts on 100% oxygen, weaned to saturation.
Breathing
Start PPV
Apnoea, gasping or heart rate under 100/min · check heart rate within 15 s, then after 30 s of PPV that moves the chest
40–60 breaths/min
Starting oxygen (with a blender)
21% from 35 weeks, 21–30% under 35 weeks · titrate to the SpO₂ targets
Enter gestation
CPAP
Breathing, heart rate over 100/min, but laboured breathing or persistent cyanosis · T-piece or flow-inflating bag
5 cmH₂O, up to 8
Chest not moving
Mask, Reposition, Suction, Open mouth, Pressure up, Alternative airway
MR. SOPA
Notes
From chapter 9 of the MPLS Provider Manual (2022), which adapts the 8th edition Neonatal Resuscitation Program. It is written for staff outside the delivery suite and applies to babies in the first few weeks of life.
Ventilation comes first. Adrenaline is only for a heart rate still under 60/min after 30 s of effective PPV and another 60 s of compressions with PPV on 100% oxygen. If it stays under 60/min, consider hypovolaemia and pneumothorax.
The manual gives one IV adrenaline dose, 0.2 mL/kg of 1:10,000, rather than the 0.1–0.3 mL/kg range in NRP itself.
Source
Paediatric Sub Committee, National Committee on Resuscitation Training (NCORT). Malaysian Paediatric Life Support (MPLS) Provider Manual. 1st ed. 2022.