Infusions Flashcards
Dextrose 50%) Dynamics:
Indications:
Contra:
Dose:
Dextrose 50% Electrolyte / Carbohydrate. Water-soluble
monosaccharide Correction of hypoglycemia Known hyperglycemia D50: 25 grams IV/IO, D10 in 50 mL (5 grams)
IV/IO boluses (max 250 mL)
Dextrose birth - 2Mns dose:
5 - 10 mL / kg of D10
Dextrose >Yrs dose:
1 - 2 mL / kg of D50
Dextrose Pediatric Dosing
- Neonate (<2 months): D10W, 5-10 mL/kg IV
- Infant (2Mn-2Yrs): D25W, 2-4 mL/kg IV
- Child (>2Yrs): D50W, 1-2 mL/kg IV
Dextrose Pedis) Above 2Yrs
2Mns -2Yrs
Birth to 2Mn:
= D50 (1-2 mL’s/kg)
= D25 (2-4 mL’s/kg)
= Birth to 2 months – D10 (5-10 mL’s/kg)
“Bigger kid Big sugars”
Dextrose 2Mns - 2Yrs dose:
2 - 4 mL / kg of D25
Dextrose 50%)
Dose:
D50: 25 grams IV/IO, D10 in 50 mL (5 grams)
IV/IO boluses (max 250 mL)
Dextrose 50%) D50:
D50 to D25:
D50 to D10:
= 25G/50mLs (0.5/mL)
= Dilute by a factor of 2 (add equal Vol of fluid)
= Dilute by a factor of 5 (add 4x Vol of fluid)
Diltiazem/Cardizem) clinical notes:
= Ca-blocker so dilatate for HypoBP ~5mg/mL vials & use 10mL syringe to dilute for push
Diltiazem/Cardizem)effects:
1st dose:
2nd dose:
= HypoBP, Pos/ CHF if used w/ beta-blockers , N/V/D, Dizziness, H/A
= 0.25mg/kg w/ max dose of 20mg
= 0.35 mg/kg w/ max dose of 25mg
Dopamine) Effects:
Dosing:
Adult & Pedi Cardiac dose:
Adult & Pedi Vasopressor dose:
= HyperBP, Palp/s, H/A, Dizzy, Can worsen C-ischemia, necrosis W/ Extravasation
= 2–20 mcg/kg/min Titrate to response
= 5-10mcg/kg/min
= 10-20 mcg/kg/min
Dopamine) Effects:
Dosing:
Adult & Pedi Cardiac dose:
Adult & Pedi Vasopressor dose:
= HyperBP, Palp/s, H/A, Dizzy, Can worsen C-ischemia, necrosis W/ Extravasation
= 2–20 mcg/kg/min Titrate to response
= 5-10mcg/kg/min
= 10-20 mcg/kg/min
Epinephrine 1:10) Pedi BradyC/Arrest:
Hypoperfusion & Severe anaphylaxis:
= 0.01 mg/kg or 0.1 mL/kg (bc 1mg in 10mL)
= 0.1-1 mcg/kg/min infusion (Mix 1mg of Epi 1:10 into 1L bag)
Epinephrine 1:10) Admin via:
Infusion
MM trick
= IV
= 0.1-1 mcg/kg/min infusion by Mixing 1mg of Epi 1:10 into 1L IV bag
= 0.1mL
Epinephrine 1:10) Effects:
Admin via:
(Adult) Cardiac Arrest dose:
(Adult) Bradycardia dose:
(PEDI) Bcardia/Cardiac Arrest dose:
(PEDI) Hypoperfusion & Severe anaphylaxis dose:
= Palpitations, Anxiety, Jitters, H/A, Dizziness, HyperBP, Tcardia, Can worsen cardiac ischemia
= IV infusion drip
= 1mg IVP/IOP every 3-5 mins
= 2-10 mcg/min IV/IO infusion
= 0.01 mg/kg or 0.1 mL/kg
= 0.1-1 mcg/kg/min infusion by Mixing 1mg of Epi 1:10 into 1L IV bag
Epi 1:10) Bradycardia dose:
Hypoperfusion & Severe anaphylaxis:
= 2-10 mcg/min IV/IO infusion
= 0.1-0.5 mcg/kg/min. Mix 1mg of Epi 1:10,000 into 1L bag of fluid.
Fluids)(Parkland Burn Form) EX: 32yo male found with 10% BSA 1st degree burns, 10% BSA 2nd degree burns, and 10% BSA 3rd degree burns. The patient is 110 pounds.
A) 4 mL x BSA x Weight (kg)
B) Total mL / 2 = (Amount to give for:
C) How many mL’s per hr?
D) How many gtts/min using a 10 gtt/mL IV drip set?
E) Know w/ formula:
A) 4mL X 20 (2nd + 3rd degree burns) X 50 (kg) = 4000 mL
B) 4000 mL / 2 = 2000 mL (Amount to give 1st 8 hours then next 16Hrs)
C) 2000 mL / 8 = 250 mL per/hour for 1st 8 hrs
D) 42 gtts/min
E) Pick closest option choice for gtts & Vol calculated. Use biggest bores& macro drips
Fluids) Pedi) Hypovolemia& Distributive fluid Form:
= 20 mL/kg / 5-10Mins PRN 3x
Fluids) Pedi replacement after perfusion rule:
4 2 1rule/ formula :
= normovolemia Used for every hr after to maintain
4ml/kg 1st 10kg
2m/Kg 2nd 10kg
1ml/kG 3rd
Fluids) Pedi) Poisoning CCB/BB fluid form
= 5-10 mL/kg / 10-20Mins PRN 3x
Fluids) Pedi) Cardiogenic Shock fluid form
= 5-10 mL/kg / 10-20Mins PRN 3x
Fluids) Parkland Burn Form for:
form:
= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs
Fluid Pedi doses) Hypovolemia& Distributive:
Cardiogenic Shock:
Poisoning CCB/BB:
DKA with Compensated Shock:
= 20 mL/kg / 5-10Mins PRN 3x
= 5-10 mL/kg / 10-20Mins PRN 3x
= 5-10 mL/kg / 10-20Mins PRN 3x
= 10-20 mL/kg / 60-120 Minutes 3x
Hydroxocobalamin/ Cyanokit) Kit has:
250mL bag w/ 10gtts:
= 2 vial (5Gs), 10gtts
=167 gtts/min
