Pediatric Dosing Charts Coming Soon to the Ontario Paramedic Clinical Guide

Providing safe, timely care to pediatric patients often means making rapid decisions in some of the most stressful clinical situations paramedics encounter. A new tool, coming soon to the Ontario Paramedic Clinical Guide app, is designed to make that work easier at the point of care.

The Pediatric Dosing Charts will be integrated directly into the app, bringing a familiar reference into clinical practice. These charts are designed to help paramedics quickly and accurately determine medication dosages for pediatric patients, with dosing expressed in millilitres to reduce cognitive load during high-pressure calls.

This is about more than convenience. It is about supporting consistent, reliable medication dosing when it matters most.

What this tool does

The charts are weight-based, with age included as a reference, and use standardized weight ranges aligned with pediatric length-based systems. For the most accurate dosing, paramedics should always confirm the child’s weight when possible and prioritize weight over age if there is a mismatch.

Key design features include:

• Dosing presented in mL to align with how medications are drawn up in practice
• Volumes rounded for common syringe sizes (1 mL, 3 mL, 10 mL) to reduce calculation steps
• Colour coding that aligns with standard pediatric tapes and charts
• Clear indication of maximum doses where applicable

These design choices aim to reduce mental workload and support accuracy in real time.

Supporting safe medication administration

The charts are intended to complement, not replace, paramedic clinical judgment and existing medical directives.

Important use considerations include:

• Always confirm medication concentration before administration
• Cross-check medications with your partner 
• Recognize that some medications may require Base Hospital Physician authorization prior to administration, depending on the directive

Not all medications or concentrations used in practice are included in the charts. When differences exist, paramedics should calculate dosing based on their local supply.

From reference to practice

The Pediatric Dosing Charts have been endorsed by the RPPEO Medical Director, reinforcing their role as a safe and reliable tool to support medication dosing in pediatric care.

This work builds on the efforts of the team at Sunnybrook Centre for Prehospital Medicine, who developed the Pediatric Dosing Charts to support safe, practical medication dosing in the field. Their work reflects a strong focus on usability, safety, and real-world paramedic practice, and now forms part of a broader provincial approach through the Clinical Guide.

Accessing the tool

For those who prefer to review or use the charts in a standalone format, a PDF version is available.

• Download the Pediatric Dosing Charts (PDF)

Reviewing the PDF version allows paramedics to familiarize themselves with the tool ahead of its introduction into the app and consider how it fits into their own practice.

What to do now

• Review the charts in PDF format
• Consider how weight-based, mL dosing aligns with your current practice
• Discuss with your partner or team how you would use this tool on a pediatric call
• Identify any differences in medication concentrations in your service

Early familiarity will help transition to using this new tool when it becomes available in the app.