Pediatric Flashcards
Assessment of a pediatrics patient requires what?
Observation, auscultation, and palpation
To start compression with HR <60 patient must be how old?
8 years old or less
Pediatric tachycardia:
•sinus tachycardia infant and child rate?
•symptomatic tachycardia infant and child rate?
Sinus=Infant <220; child <180 w/ narrow QRS
Symptomatic=infant >220; child >180 w/ signs of poor perfusion
Pediatric Tachycardia:
- Stable:N QRS(=>0.08); Infant>220/child>180(SVT)
- unstable:N QRS(=>0.08); infant>220/child>180(SVT)
- wide QRS (>0.08) Ventricular Tachycardia
- adenosine only
- adenosine then cardio version
- cardio version only
Note: 0.1mg/kg max first 6mg, repeat double max 12mg
~ 0.5-1J/kg if not effective increase to 2
~midazolam: 0.1mg/kg max dose 4mg
Pediatric Shock: ~cap refill ~BP less than ~place patient in ~Ketamine dose ~midazolam dose and max dose
- 3 or greater
- Systolic less than 70
- Supine position
- 2mg/kg
- 0.1 max 4mg
Ventilation w/ BVM rate
~premature neonate and neonate
~infant and children
- 40 to 60 per min
* 12-20 per min (once every 3 to 5 sec)
Pediatric Normal Respiratory Rates: Infant Toddler Preschooler School-age Adolescent
>1= 30-60 1-3= 24-40 4-5= 22-34 6-12= 18-30 12-18= 12-20
- Mild Croup
* Moderate to Severe Croup
•NS 5ml nebulized
•0.5mg Epi 1:1000 in 5ml NS nebulized
~ side effects: Tachy, tremors, vomiting
Supra-glottic airway if child is how tall? Place after how may attempts of intubation?
4ft or taller
After two attempts
Pediatric Asthma:
•mild
•moderate
•severe
- mild/ albuterol and atrovent
- moderate/ albuterol and atrovent + mag+ solu-medrol
- severe/ epi+ cpap w/ inline albuterol and atrovent+ mag+ solu-medrol
Doses:A and A-5mg+0.5/ mag 50mg/kg in 100ml bag max 2grams/ SM-2mg/kg max125/ epi1:1000 0.1mg/kg IM only max dose 0.3mg
What is preferred over intubation w/ pediatric Asthma
Treatment w/ medication and/or CPAP
Pediatric V-fib/pulseless V-Tach ~Compressions infants and children •depth •rate ~J/KG ~drugs
•1/3 diameter of chest
~infants-1 1/2 inches
~children-2 inches
- 15:2 before advanced airway then continuous breaths every 6 seconds
- 1st shock 2J/KG, second and the rest 4J/KG
•drugs: Epi; Amiodarone; Mag
~doses: Epi 1:1000- 0.01mg/kg
~Amio- 5mg/kg max300mg; same max 150
~Mag- torsades- 50mg/g max 2grams
Pedi-Immobilizer infants and children?
Less than 60lbs for spinal immobilization
Pediatric compressions and breaths with out advanced airway?
15:2 after advanced airway continuous rate of 120/min one breath every 6-8 seconds
Note: adult is 30:2
Peds VFib and Pulseless VTach:
Doesn’t mention what?
H’s and T’s
Peds Asystole says what that’s super weird?
No medication has been shown to reduce mortality in cardiac arrest!!!
???????????
H's and T's Peds Asystole: That receive drugs: ~ hypovolemia ~hydrogen ion= acidosis ~hypoglycemia ~toxin/ tablets
- NS 20mg/kg repeat once if needed
- Sodium Bicarb/ 1mEq/kg(max single 50mEq)
•neonate0-1/ D10W at 5ml/k if <45
•infant/child1m-12y/ D25W at 2ml/kg <60
•adolescent13-18/D50W at 1ml/kg <60
~ below 50 repeat appropriate dose
•Narcan/ 0.1mg/kg max 2mg
Pediatric Asthma:
Mild
Moderate
Severe
- wheezes only= albuterol and atrovent
- wheezes/decreases breath sounds/ accessory muscle use= Ab and Atro+ Mag+ Solu-Medrol
- wheezes/stridor/decreased breath sound with little or no air movement/ accessory muscle use/tripoding= Epi 1:1000+ CPAP w/ Ab and Atro+ Mag+ Solu-Medrol
Doses: Ab and Atro normal; Mag 50mg/kg(max2grams); Solu-Med 2mg/kg(max125)
Epi 0.01mg/kg IM only max 0.3mg
Pediatric Allergic Reaction/ Anaphylaxis:
Mild
Moderate
Severe
•without Respiratory compromise
Benadryl 1mg/kg may 25mg
•Respiratory compromise
AB and Atro + Benadryl+ Solu-Med
•Sever Respiratory compromise
Ab and Atro+ Epi+ Benadryl+ Solu-Med
:Doses: Alb normal unless less than 10kg 2.5
~Epi1:1000 0.01mg/kg IM only max single 0.3
~Solu-Med 2mg/kg max 125mg
~all are IV/IO/IM slow push except Epi IM only
Pediatric Altered Consciousness:
Position patient how
Hypoglycemia:
Hyperglycemia:
Narcotic use:
•Hypo=normal for neo; infant/child; adolescent
~hypo w/o IV= glucagon
•less than 20kg 0.5mg IM
•20kg or greater 1mg IM which is normal
~Narcan 0.1mg/kg IV/IO/IM max single 1mg
If no change in 5min repeat 0.1mg/kg max total 2mg
Note: Narcan in adults you wait 2min not 5min before repeating also second dose is total of 1mg not 2mg. However in arrest it is 1-2mg.
I think it’s a mistake but know it!!!
Pediatric Overdose/ Poisoning:
Seizures
Tricyclic Anti-depressant
Narcotic use
Organophosphate exposure
Acute Dystonic Reaction to Ani-psychotics
•Seizures= midazolam 0.1mg/kg max 4mg may repeat once
•Tricyclic= NS 20ml/kg repeat once
Sodium Bicarb 1mEq/kg max single 50mEq
- Narcan= 0.1mg/kg max single 1mg, no change in 5min repeat 0.1mg max total 2mg
- Organo= Atropine 0.05mg/kg min single dose 0.1mg and max initial dose 2mg; repeat every 3-5 min until dry
•Anti-Psychotics= Benadryl 1mg/kg max 25mg
~ signs and symptoms= painful muscle spasms to face, neck, and back
Pediatric Seizure:
Drug:
Hypo:
- midazolam 0.1mg/kg max single 4mg may repeat once
* What it always is for Peds, doesn’t actually mention Glucagon
Pediatric Fever:
Patient is febrile if temp is?
If pediatric patient has a temp greater than____ and the parents has ibuprofen or acetaminophen:
Rectal >105.0 or tympanic >104.0
Apply cooling measures
102.0
Ibuprofen 10mg/kg not for children under 6months
Acetaminophen 15mg/kg
