Pediatric chemical restraint ketamine dosing is 1 mg/kg IV/IO/IM diluted, may repeat 3x. What is the maximum IM dose in milliliters?

• A. 4 ml
• B. 6 ml
• C. 2 ml
• D. 8 ml

Answer: (A)

The dosing concept here is converting mg/kg to mL once you know the dilution. Each IM dose is 1 mg per kg, and you may repeat this up to 3 times. That means a total of 4 mg per kg can be given (initial dose plus three repeats). If the ketamine is diluted to 1 mg per mL, then each dose equals 1 mL per kg, and over four doses the total volume is 4 mL per kg. Therefore, the maximum IM dose in milliliters is 4 mL.