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Fa: Sim 3 > 2. Peds/Neonates > Flashcards

2. Peds/Neonates Flashcards

1
Q

narrowest part of airway

A

cricoid carilage

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1
Q

RR

A

increased

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2
Q

metabolic consumption

A

increased
6-8 mL/kg/min

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3
Q

lung compliance

A

reduced

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4
Q

chest wall compliance

A

increased

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5
Q

FRC

A

reduced

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6
Q

head/tongue

A

larger

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7
Q

nasal passages

A

narrower

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8
Q

larynx

A

anterior
cephalad

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9
Q

epiglottis

A

longer

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10
Q

trachea/neck

A

shorter

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11
Q

adenoids/tonsils

A

more prominent

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12
Q

intercostal/diaphragm muscles

A

weaker

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13
Q

resistance to airflow

A

greater

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14
Q

neonates and infants are obligate

A

nasal breathers

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15
Q

CV is dependednt on

A

HR

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16
Q

HR

A

increased

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17
Q

BP

A

reduced

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18
Q

LV

A

non-compliant

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19
Q

CV summary: peds

A

1) HR-dependent CO
2) incr HR
3) reduced BP
4) non-compliant LV
5) residual fetal circulation
6) potential difficult venous/arterial cannulation

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20
Q

BSA is _______

A

larger

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21
Q

how do neonates warm themselves?

A

brown fat metabolism for nonshivering thermogenesis

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22
Q

what inhibits brown fat metabolism

A

anesthesia

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23
Q

BSA calculation

A

BSA = sqrt[(height x weight)/3600]

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24
Q

when does peds renal function normalize

A

6 months

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25
Q

peds glycogen

A

reduced which can cause hypoglycemia

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26
Q

peds drug dosing should be

A

allometric

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27
Q

50th percentile for weight

A

(Age x 2) + 9

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28
Q

neonate TBW

A

more than that of an adult

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29
Q

incr TBW =

A

incr volume of distribution of drug
== higher dosing needed

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30
Q

which pt population has highest anesthetic requirement for inhalational?

A

3 month olds

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31
Q

fast emergence can cause

A

incr risk of post-op delerium

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32
Q

volatile agent impact on myocardium

A

sensitizes myocardium to catecholamines

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33
Q

propofol infusion syndrome SE

A

HD instabolity
brady
hTN
green urine

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34
Q

propofol infusion most common pt

A

critically ill children

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35
Q

opioids peds

A

more pronounced effect due to immature mu receptors

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36
Q

remi dosing for peds

A

need to increase dosing due to incr clearance

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37
Q

dexmedetomidine nasal sedation dose

A

1-2 mcg/kg

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38
Q

muscle relaxants

A

NOT commonly used unless necessary

39
Q

NDMB dosing

A

lower dosing due to immature NMJ

40
Q

Roc IM dose

A

1-1.5 mg/kg

41
Q

Roc IM onset

A

3-4 min

42
Q

reversal options

A

1) neostigmine+glyco
2) edrophonium + atropine
**can use sugammadex

43
Q

sugammadex SE

A

bradycardia

44
Q

sux dosing

A

higher dosing
2-3 mg/kg

45
Q

what should you give with sux

A

atropine

46
Q

sux SE

A

arrhythmias
hyperkalemia
rhabdomyolysis
myoglobinemia
masseter spasm
MH

47
Q

Sux + atropine IM dosing

A

sux IM: 4-6mg/kg
atropine: 0.02 mg/kg

48
Q

what can incr risk of airway complications?

A

URTI
2nd hand smoke exposure

49
Q

risk of aspiration

A

greater

50
Q

risk of dehydration

A

greater

51
Q

NPO: clear fluids

A

2 hrs

52
Q

NPO: milk/formula

A

4 hrs

53
Q

NPO: light meal

A

6 hrs

54
Q

pre-meds

A

versed
ketamine
demedetomidine
fentanyl lollipops
versed + ketamine

55
Q

versed IM

A

0.25mg/kg

56
Q

versed oral

A

0.25-0.7 mg/kg
up to 20 mg

57
Q

ketamine IM

A

4-6 mg/kg IM
w/atropine 0.02 mg/kg IM

58
Q

dexmedetomidine nasal

A

1-2 mcg/kg nasal

59
Q

versed+ketamine IM

A

versed: 0.1-0.15 mg/kg
ketamine: 2-3 mg/kg ketamine IM

60
Q

mask induction speed

A

rapid

61
Q

why is peds mask induction rapid?

A

high MV:FRC ration
incr CBF
decr B:G coefficient

62
Q

induction mixutre

A

70% N2O
30% O2

63
Q

steal induction

A

for agitated child
high flow
O2
N2O
8% sevo

64
Q

common IV locations

A

saphenous
AC
hand
wrist

65
Q

IO cannulation size

A

16-18g needle

66
Q

how long can you use an IO for?

A

24 hours

67
Q

IO CI:

A

fracture
burn
infection
osteogensis imperfecta
osteoporosis
previous IO attempt w/i 48hrs
recent sx on bone

68
Q

IO sternum pt population

A

> 12 years old

69
Q

IO cannulation sites

A

sternum
humerus
distal femur
proximal tibia
distal tibia

70
Q

distal femur IO

A

1 cm prox to patella
1-2 cm medial

71
Q

prox tibia IO

A

1-2 cm inferior and medial to tibial tuberosity

72
Q

distal tibia IO

A

2cm prox to medial malleous

73
Q

ETT meds

A

Naloxone
Atropine
Vasopressin
Epinephrine
Lidocaine

74
Q

ETT med dosing

A

2-2.5x IV dose
dilute with 5-10 mL NS

75
Q

what should you do after giving ETT meds

A

ventilate rapidly with large breaths

76
Q

tube diameter

A

Age/4 + 4

77
Q

tube length

A

Age/2 + 12

78
Q

when do you use uncuffed ETT

A

greater than 4.0 size

79
Q

peds ventilation

A

almost always mechanical

80
Q

peds ventilator considerations

A

limit dead space

81
Q

peds fluids management

A

4:2:1
goal directed therapy

82
Q

buretrol

A

allows higher acuracy fluid admin

83
Q

preterm neonate BV

A

100 mL/kg

84
Q

full term neonate BV

A

85-90 mL/kg

85
Q

infants BV

A

80 mL/kg

86
Q

transfusion target critically ill

A

40%

87
Q

PLT dose

A

10-15 mL/kg

88
Q

FFP dose

A

10-15 mL/kg

89
Q

cryo dose

A

1 unit/10kg weightcva

90
Q

caudal dosing

A

2 mg/kg 0.25% marcaine w/epi

91
Q

needle for caudal

A

22g

92
Q

laryngospasm treatment

A

PPV
jaw thrust
propofol
lidocaine (1-1.5 mg/kg)
muscle relaxant

93
Q

emergence positioning

A

rescue position

94
Q

Croup treament

A

decadron
recemic epi
- 0.25-0.5 mL 2.25% in 2.5 mL NS

95
Q

delerium risk factors

A

preschool
male
sevo/des
ENT
pre-op anxiety
parental anxiety
child temperment

96
Q

deleriume prophylaxixs

A

precedex : 0.25-5 mcg/kg before wakeup
propofol bolus
reduced VA

Fa: Sim 3 (10 decks)

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