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Paediatrics > Drug Protocols > Flashcards

Drug Protocols Flashcards

1
Q

Adrenaline Indications

A

Cardiac ArrestAnaphylaxis or severe allergic reactionSeere life-threatening bronchospasm OR silent chest (only able to speak in single works AND/OR silent chest AND/OR haemodynamic compromise AND/OR an ALOC)Bradycardia with poor perfusion (unresponsive to atropine AND/OR TCP)Croup (with stridor at rest)Shock unresponsive to adequate fluid resuscitation (excluding haemorhagic cause)

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2
Q

Adrenaline DosagesAnaphylaxis OR severe allergic reaction

A

IM - ACP1, ACP2, CCP≥ 6 years - 300 microgrepeat at 5 minute intervals. No max dose< 6 years - 150 microgRepeat at 5 minute intervals. No max dose.IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 minute intervals. No max dose.NEB - ACP2, CCP5mg Single dose only

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3
Q

Adrenaline DosagesSevere life-threatening bronchospasm OR silent chest

A

IM - ACP1, ACP2, CCP≥ 6 years - 300 microgrepeat at 5 minute intervals. No max dose< 6 years - 150 microgRepeat at 5 minute intervals. No max dose.IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 minute intervals. No max dose.

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4
Q

Adrenaline DosagesCardiac Arrest

A

IV - ACP2, CCP≥ 10kg (≥ 1 year) - 10microg/kgRepeat at 3-5 minute intervals. No max dose.<10kg (<1 year) - 100 microgRepeat at 3-5 minute intervals. No max dose.

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5
Q

Adrenaline DosagesCroup

A

NEB - ACP2, CCP5mg. Single Dose only.

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6
Q

Adrenaline DosagesShock Unresponsive to adequate fluid resus

A

IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 min intervals. No max dose.

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7
Q

Adrenaline DosagesBradycardia with poor perfusion

A

CONSULT!

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8
Q

Amiodarone Paediatric Indications

A

Cardiac arrest (refractory VF or pulse-less VT)

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9
Q

Amiodarone DosagesCardiac Arrest

A

IV/IO5mg/kgSlow push over 2 minutesSingle dose only

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10
Q

Atropine Indications

A

Bradycardia (with poor perfusion)Envenomation (with increased parasympathetic activity)Hypersalivation (secondary to ketamine administration)Organophosphate toxicity (with cardiac AND/OR respiratory compromise)

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11
Q

Atropine DosagesBradycardia

A

IV/IO - CCP20 microg/kg (Single dose not to exceed 600 microg) Repeat ONCE at 2 minutes.Total max dose 40 microg/kg

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12
Q

Atropine DosagesEnvenomation and Organophosphate toxicity

A

IM/IV/IO - ECP, CCP (IO CCP only)20 microg/kg (Single dose not to exceed 600 microg)Repeat at 5 minute intervals. No Max dose.

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13
Q

Atropine DosagesHypersalivation

A

IV - CCP20 microg/kg (single dose not to exceed 600 microg)Single dose only

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14
Q

Calcium Gluconate Paediatric Indications

A

Suspected Hyperkalaemic cardiac arrestSevere HyperkalaemiaCalcium Gluconate Blocker toxicityHypotension associated with Magnesium infusion (that fails to respond to IV fluid therapy)

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15
Q

Calcium Gluconate DosagesAll indications

A

IV/IO - CCP0.5 mL/kg (or 50 mg/kg)Slow push over 2-5 minutes.Repeated once at 10 minutes.

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16
Q

Ceftriaxone Indications

A

Suspected meningococal septicaemia (with a non-blanching petechial and/or purpuric rash)

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17
Q

Ceftriaxone Dosages

A

IM - ACP1, ACP2, CCP50 mg/kg (rounded up to the nearest 5kg)Reconstitute in 3.6mL water for ingection.IV/IO - ACP2, CCP (IO CCP ONLY)50 mg/kg (rounded up to the nearest 5kg)Reconstitute in 9.6mL water for ingection.

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18
Q

Fentanyl Indications

A

Significant PainSedation (for maintenance of established ETT)

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19
Q

Fentanyl DosagesSignificant Pain

A

NAS - ACP2, CCP≥ 1 year (CCP 6 months) - 1.5 microg/kgRepeat at 1 microg/kg at 10 minutes.< 1 year (CCP 6 months) - CONSULTIM - ACP2, CCP≥ 1 year - 1-2 microg/kg (CCP 2 microg)Single max dose 50 microgTotal max dose 2 microg/kg< 1 year - CONSULTIV - ACP2, CCP≥ 1 year - 1microg/kgSingle max dose 25 microgRepeat at 0.5 microg/kg (max 25 microg) at 5 minutes.Total max dose 2 microg/kg. (CCP - no max dose)< 1 year - CONSULT

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20
Q

Fentanyl DosagesSedation

A

IV/IO - CCP≥ 1 year - 1 microg/kgSingle max dose 25 microgConsider administration with midazolam. No max dose.<1 year - Consult

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21
Q

Glucagon Indications

A

Symptomatic hypoglycaemia (with inability to self-administer oral glucose)

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22
Q

Glucagon Dosages

A

> 25 kg - 1 mg single dose only.≤ 25 kg - 0.5 mg single dose only.

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23
Q

Glucose 10% Indications

A

Symptomatic hypoglycaemia (with inability to self-administer oral glucose)

24
Q

Glucose 10% Dosages

A

IV/IO - ACP2, CCP (IO CCP only)0.25 g/kg (2.5mL/kg)Repeat at 1mL/kg boluses every 5 minutes until BGL < 4.0 mmol/L

25
Q

Glucose gel Indications

A

Symptomatic hypoglycaemia (with ability to self-administer oral glucose)

26
Q

Glucose Gel Dosages

A

PO - ACP1, ACP2, CCP≥ 2 years - 15gRepeat once at 15 minutes if BGL <4 mmol/LTotal max dose 30g

27
Q

Glyceryl Trinitrate Paediatric Indications

A

Autonomic Dysreflexia (SBP > 160 mmHg)Irukandji Syndrome (SBP > 160 mmHg)

28
Q

GTN DosagesAll inidcations

A

Sublingual - ACP2, CCPCONSULT

29
Q

Hydrocortisone Indications

A

Moderate or Severe AsthmaSevere allergic reaction OR anaphylaxis (requiring adrenaline (epinepherine) administration)Symptomatic adrenal insufficiency

30
Q

Hydrocortisone DosagesModerate or Severe AsthmaSevere allergic reaction OR anaphylaxis

A

IM/IV - ECP (with consult), CCP5mg/kg Single dose only. Not to exceed 100mg)IV single dose only

31
Q

Ipratropium Bromide Indications

A

Moderate OR severe bronchospasm

32
Q

Ipratropium Bromide Dosages

A

NEB - ACP1, ACP2, CCP≥ 2 years - 250 microg. Single dose

33
Q

Ketamine Paediatric Indications

A
  • Severe traumatic pain (following 0.2mg-0.2mg/kg morphne or 1-2 microg/kg fentanyl) associated with: - fracture reduction and splinting - multiple or significant fractures requiring facilitated extrication - Patients with splinted fractures requirign ongoing narcortic analgesia for transport requirements)Induction of anasethesia- Severe traumatic pain associated with burns- Ongoing traumatic pain unresponsive to narcotics (following 0.2-0.3 mg/kg morphine OR 2-3 microg/kg fentanyl)
34
Q

Ketamine DosagesSevere traumatic pain associated with burns

A

IV - CCPCONSULT

35
Q

Ketamine DosagesOngoing traumatic painSevere traumatic pain

A

IV - CCP> 1 year - 100microg/kg (0.1mg/kg)Repeate every 2-3 minutesTotal max dose 1mg/kg

36
Q

Ketamine DosagesInduction of anaesthesia

A

IV/IO - ECCP0.25-2mg/kgSingle dose onlyTotal max dose 100mg

37
Q

Magnesium Sulphate Indications

A

Irukandji SyndromeSever Life-threatening asthmaTorsades de PointesBox jellyfish envenomation

38
Q

Magnesium Sulphate DosagesIrukandji syndrome and Box jellyfish envenomation

A

IV - E.ACP2, CCP0.1 mmol/kg over 15 minutes (rounded p to nearest 0.5 mmol). Single max dose 5 mmolRepeat once at 10 minutesTotal max 10 mmol.

39
Q

Magnesium Sulphate DosagesTorsades de Pointes

A

IV/IO - CCP0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol)Single dose not to exceed 5 mmolRepeat once at 10 minutesTotal max dose 10 mmol

40
Q

Magnesium Sulphate DosagesSevere life-threatening asthma

A

IV/IO - CCP0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol)Single dose not to exceed 5 mmol

41
Q

Midazolam Indications

A

Generalized seizures/focal seizures (GCS < 12)SedationAcuute behavioural disturbance (with SAT score at 2 or >)

42
Q

Midazolam DosagesGeneralized Seizures/focal seizures

A

NAS - ACP2, CCP200 microg/kgSingle dose not to exceed 5mg.Repeat at half the initial dose at 10 minutes (max 0.25mg)Total Max 10mgIM - ACP2, CCP200 microg/kgSingle dose not to exceed 5mg.Repeat at half the initial dose at 10 minutes (max 0.25mg)Total Max 10mgIV/IO - CCP100mcg/kgSingle dose not to exceed 2.5mgRepeat at 5 min intervalsTotal max dose 10mg

43
Q

Midazolam DosagesSedation

A

IV/IO - CCPUp to 100 microg/kgSingle dose not to exceed 2.5mgRepeat at 3-5 minute intervalsTotal max dose 5mg

44
Q

Midazolam DosagesAcute Behavioural disurbance

A

IM (only if IV access not acheiveable)≥ 8 years - 200 microg/kgSingle dose only. Max 5mgIV - CCP≥ 8 years - 100 microg/kgSingle dose only. Max 2.5mg

45
Q

Naloxone Indications

A

Respiratory depression (secondary to administration of narcotic drugs)

46
Q

Naloxone Dosages

A

IM - ACP2, CCP20 microg/kgSingle dose only. Not toe xceed 800 microg.

47
Q

Ondansetron Indications

A

Nausea AND/Or vomiting

48
Q

Ondansetron Dosages

A

IM - ACP1≥ 5 years - 2mgSingle dose onlyIM - ACP2, CCP≥ 3 years - 100 microg/kgsingle dose only, not to exceed 4mgIV - ACP2, CCP≥ 3 years - 100 microg/kgsingle dose only, not to exceed 4mgSlow push over 2-3 minutes

49
Q

Paracetamol Indications

A

Minor painFever (causing distress)

50
Q

Paracetamol Dosages

A

PO - ACP1, ACP2, CCP≥ 1 month - 15mg/kgSingle dose only

51
Q

Promethazine Paediatric Indications

A

Symptomatic rash/moderate allergic reactions

52
Q

Promethazine Dosages

A

IV - ECP (CONSULT), CCP≥ 2 years - 250 microg/kgSingle dose only. Not to exceed 12.5mgSlow push over 1 minutes

53
Q

Salbutamol Indications

A

BronchospamsSuspected hyperkalaemia (with QRS widening AND/OR dissociation)

54
Q

Salbutamol DosagesBronchospasm

A

NEB - ACP1, ACP2, CCP≥ 2 years - 5mgRepeated PRNNo max doseIV - CCP≥ 2 years - 5microg/kgSingle dose not to exceed 250 microg.Repeat once at 10 mintues

55
Q

Salbutamol DosagesSuspected hyperkalaemia

A

NEB - CCP5mg - Single dose only

56
Q

Sodium Bicarbonate Paediatric Indications

A

Cardiac ArrestSuspected hyperkalaemiaSignificant injury with potential for crush injury

57
Q

Sodium Bicarbonate DosagesAll indicatiosn

A

IV/IO - ECP, CCP (IO CCP only)1mL/kg - Single Dose onlyECP must Consult

Paediatrics (5 decks)

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