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Rounding Medication Doses

Question# 719

When preparing medication, for example IM Midazolam for a 36kg pt, the 0.2mg/kg dose would be 7.2mg. Using a 5mg/ml concentration that would be 1.44ml volume of medication. Using a 3ml syringe, I would only be able to accurately measure 1.4ml dose.

Is it acceptable to round down the dose in this circumstance? In this case rounding down to 7mg to allow accurate dosing?


The Companion Document states, "Medication doses may be calculated based upon weight or other factors and result in a fraction that cannot be measured accurately. Depending on the delivery method used, medication doses may require rounding from the exact dose calculated. In these cases the medication dose delivered will be rounded to the closest dose that can accurately be measured." (Pg. 3)

As always, it is encouraged to document this in order for anyone reviewing the form to follow your math.


Companion Document Pg. 3


14 July 2023

ALSPCS Version




Please reference the MOST RECENT ALS PCS for updates and changes to these directives.