77. Pediatric Flashcards
APGAR score
Appearance
Pulse <100
Grimace
Activity
Respiration
GFR According to age
1 day 24
2-8 days 38
10 - 22 days 50
37 - 95 days 58
1 -2 years 115
Gastroschisis vs omphalocele
Gastroschisis Viscera not covered
Omphalocele covered by peritoneum
What to do omphalocele b4 the surgery
Echo to assess heart function
How much to postpone a surgery in case of severe cold
2 weeks
VACTERL
Vertebral
Anal
Cardiac
Tracheal Esophageal
Renal
Limbs
What’s transitional circulation. MoA and causes
TC. coming back to fetal circulation after dellivery
Increase of pulmonary blood pressure
Risk. Acidosis, infection, prematurity, hypercapnia or hypoxemia
Most common arrhythmia in pediatric
Hypoxia induced bradicardia
VR rare
Liver function in newborns
Liver maturity is incomplete
P450 (phase I) works 50%
Phase II impaired (some reactions can take until a year)
Hematology in newborn
Increase EPO
F Hb more affinity for O2 (shift to the left)
Turn over to mature Hb until 6 months
Hypercoagulability state
Thermoregulation in newborn
Not good. Loss of heat by conduction and convection
Warm mattress and to warm the room prevent loss by conduction
Blankets (most effective method) and incubator convection
MAC in pediatrics
In general higher, decrease with age
Peak 1-6 months
Scoline IM
< 6 m 5mg/kg
> 6 m 4 mg/kg
NDMR in kids
More sensible. Need less dose for similar effect
Sugammadex is safe with same dossage
Premedication for kids
MID 0.5 mg/kg PO
Stridor. Expiratory vs inspiratory
Expiratory intrathoracic
Inspiratory extrathoracic
Most common cause of cardiac arrest in kids
Hypovolemia
Fluid requirements for newborns
Day 1 70 cc/kg/day
Day 3 80
5 90
7 120
Blood of newborn
Preterm 120 cc/kg
term 90
3-12 m 70-80
>12 m 70
Maximum allowable blood loss
EBV x (Starting Hct - Target Hct) / St Hct
Maximum rate flow of intraosseous canula (15G)
68
294 with pressure
Test to perform before correction of traqueo esophageal fistula
Echo, to examine right sided aortic arch and heart abnormalities
Abdominal US to check for renal abnormalities
Lymphoma and Dexamethasone can cause…
Tumor lysis syndrome
Delirium in kids
Sevo greater incidence of delirium
Treatment propofol