Paracetamol Infusion Volume for a 16kg Child
For a 16kg child, administer 24 mL of paracetamol infusion (240 mg dose at 15 mg/kg), given intravenously over 15 minutes, repeated every 4-6 hours as needed, not exceeding 60 mg/kg/day (960 mg/day or 96 mL total daily volume). 1, 2
Dosing Calculation
- Standard pediatric dose: 10-15 mg/kg per dose, administered every 4-6 hours 1
- For a 16kg child:
IV Formulation Details
- Standard concentration: Commercial paracetamol IV preparations contain 10 mg/mL 2
- Volume calculation: At 10 mg/mL concentration, 240 mg = 24 mL 2
- Dilution option: Can be further diluted in 0.9% normal saline or 5% dextrose if needed, though typically unnecessary for a 16kg child 2
Administration Guidelines
- Infusion rate: Administer over 15 minutes 2
- Dosing interval: Every 4-6 hours as needed 1, 4
- Maximum daily dose: 60 mg/kg/day (960 mg/day for 16kg child = 96 mL total daily volume) 1, 3
- Maximum number of doses: Do not exceed 4-5 doses in 24 hours 1, 5
Critical Safety Considerations
- Hepatotoxicity threshold: Never exceed 75 mg/kg/day for more than 2 days, as this significantly increases risk of liver injury 6
- Cumulative toxicity: Doses exceeding 90-140 mg/kg/day for several days carry serious risk of hepatic failure 5, 7, 6
- Monitoring: If the child has received more than 75 mg/kg/day for at least 2 days, check liver transaminases, coagulation factors, and paracetamol serum concentrations 6
- Contraindications: Do not use in children with pre-existing hepatic insufficiency 3
Common Pitfalls to Avoid
- Underdosing: Many dosing schedules recommend inadequate amounts; ensure 15 mg/kg per dose for optimal efficacy 4
- Exceeding daily maximum: With 4-6 hour dosing intervals, it's easy to inadvertently exceed 60 mg/kg/day—always calculate total daily dose 1, 7
- Rectal vs IV confusion: Do not use rectal dosing guidelines for IV administration; IV has more predictable absorption 1, 3