Fentanyl - Pediatric (ALS): What is the maximum per-dose IM/IN fentanyl for a child?

• A. 50 mcg
• B. 100 mcg
• C. 200 mcg
• D. 25 mcg

Answer: (B)

In pediatric ALS, fentanyl dosing is weight-based, with a safety cap on a single administration. A typical per-dose guideline is about 1 mcg/kg, but you must never exceed 100 mcg in one IM or intranasal dose. This cap helps prevent excessive respiratory depression in children while still providing effective analgesia. So the maximum per-dose IM/IN fentanyl for a child is 100 mcg. Smaller doses (like 50 or 25 mcg) may be insufficient for many pediatric patients, while a dose of 200 mcg would exceed safety limits. If additional analgesia is needed, reassess and consider repeating dosing within the protocol, keeping within the 100 mcg per-dose maximum.