Paediatrics (Red Cross Guide)

Question 1

Estimated weight formula

Answer 1

< 12 months:
- Age (months) + 9 / 2

> 12 months:
- Age (years) x 2 + 8

Question 2

ETT size estimation

Answer 2

Age/4 + 4 (uncuffed)

Half a size smaller for cuffed tubes

Question 3

ETT length estimation

Answer 3

ETT size x 3 (+ 2 for nose) = cm at LIP

Question 4

Normal respiratory rates for ages up to 12 years

Answer 4

Neonate: 25 - 50
1 year : 20 - 40
2 -7 years: 20 - 30
8 -11 years: 15 - 25
> 12 years: 12 - 24

Question 5

Normal heart rate for ages up to 12

Answer 5

Neonate    120 - 170
1 year         110 - 160
3 year        90 - 140
6 year        80 - 130
8 - 11 year  70 - 120
> 14 years  60 - 110

Question 6

Normal systolic BP for age ranges up to 12 years

Answer 6

Neonate - 6/12 80 - 90
2 yr - 4 yr 85 - 100
5 -11 years 90 - 110
> 12 years 100 - 120

Premature babies MAP = gestational age

Question 7

What premedications are given in paediatrics at RXH and when are they given

Answer 7

Clonidine 3 - 4 mcg/kg PO: 90 minutes before

Midazolam 0.2 - 0.3 mg/kg PO: 30 minutes before (on trolley)

Question 8

What medications can be given for apnoea prevention and to which children are these administered

Answer 8

Administered to babies up to 60 weeks post conception.

Preoperative:
Caffeine citrate 20 mg/kg PO (2 hours before)

Intraoperative:
Aminophylline 5mg/kg IV slowly intraoperatively

Postoperative:
Caffeine citrate 5 - 10 mg/kg PO daily x 2 days

Question 9

What is given t children for PONV prophylaxis

Answer 9

Dexamethasone 0.15 mg/kg IV

Ondansetron 0.15 mg/kg IV

Question 10

What are the common prophylactic antibiotics administered and what is the dose

Answer 10

Cefazolin 50 mg/kg IV

Metronidazole 15 mg/kg IV

Question 11

Give the reversal agents, the doses and a practical way to prepare, draw up and administer reversal in paediatrics

Answer 11

Neostigmine: 0.05 mg/kg
Atropine: 0.02 mg/kg
Glycopyrrolate: 0.01 mg/kg

Red Cross reversal
Neostigmine 0.5mg (1 paed amp)
Glycopyrrolate 0.15 mg (0.75 ml)
IN TOTAL 10 MLS normal saline

–> Give 1ml/kg of this solution

Question 12

Which agents and what dosages are used for intra-operative analgaesia

Answer 12

IV Paracetamol 20mg/kg loading (15/mg/kg maintain)
IV Ketamine (0.25 - 0.5 mg/kg)

PR Diclofenac (1 mg/kg)
IV Clonidine (1 mcg/kg)
IV fentanyl (1 mcg/kg)
IV Morphine (0.1 mg/kg)

Question 13

Which agents and what dosages are used for post operative analgaesia

Answer 13

PO 6 hrly - Paracetamol 15 mg/kg
PO 6 hrly - Tilidine 1 drop per 2.5 kg

PO 8 hrly - Ibuprofen 10 mg/kg
PO 8 hrly - Clonidine 2 - 5 mcg/kg

Infusion - Morphine
0.5 x weight (kg) = mg drawn up into 50 mls NaCl 0.9%
RUN AT 1 - 3 ml/hour