pediatric assessment and basics Flashcards
what dose TICLS stand for
Tone
Interactive
Consolability
look (gaze)
Speech (or cry)
considerations for tone
Are they unusually floppy, like a ragdoll, unable to hold themselves upright? By six months of age, nearly all children should be able to sit up and support their own heads.
considerations for interactiveness
To a newborn child, the world is an amazing place, full of strange sights and sounds and smells. Babies have learnt to smile by about two months of age, and by a year or so, they are following objects around the room with their gaze. If they do not appear to be interested in what is going on in the world around them, then it is time to be a little more concerned.
considerations for Consolability
Children cry – all of the time. They cry because you want to brush their hair, they cry because you don’t want to brush their hair, and they cry because you have looked at them. But they are also consolable. If they can’t be consoled, despite the best efforts of their mother, then something is amiss.
considerations with cry
Crying, generally, is good, especially if it is someone else’s child and not your own, as long as they are consolable (see above). But that high-pitched squealing cry means something different entirely.
outline the triage used for paediatric assessment in the guidelines
activity
breathing
circulation
Hypoxia in children causes
tachycardia, agitation, drowsiness and pallor. Cyanosis is a late sign.
signs of shock in children
Tachycardia.
Tachypnoea.
Vasoconstriction with prolonged capillary refill time. This will also often produce mottled skin.
Reduced activity and interaction.
hypotension is late late stage symptoms
axillary temp is preferred at what age
under 6 months
estimated weight of under 1 year old
5 kg
estimate weight calculation for 1-10 year old
(Age in years + 4) x 2
11-14 weight calculation
3 x age
defibrillates joules for lead
4j per kg
HR and RR of less then one year old
110-160
30-40
1-2 year old RR and HR
100-150
25-35
2-5 HR and RR
2-5 years
95-140
25-30
how to draw up fent if weight is less then 20 kg
Draw up 2 ml of fentanyl from a 100 mcg/2 ml ampoule.
Place in a 100 ml bag of 5% glucose.
Shake well and label.
Administer the volume from the tables as an IV bolus.
how to draw up adrenaline for 0.001 mg/ml
Use a 1 litre bag of 0.9% sodium chloride.
Add 1 ml of adrenaline from a 1 mg/ml ampoule.
Shake well and label.
Administer the volume from the tables as a IV bolus.
IM adrenaline pea doses
0.1 per 10 kg
fent dose for a 10kg/1 year old
2-10 mag (2/10 ml from bag of glucose)
10% glucose dosage
2ml/kg
IV adrenaline arrest dosage
0.1 per 10 kg
10 kg / 1 year old brofen dose
100 mg
5 ml (20 mg/ml)
PO/IM ketamine dose for 10 kg 1 year old
5 mg 0.05 ml (undiluted)
levetiracetam for 10 kg / 1 year old dose
500 mg 5 ml (100 mg/ml)
IM midaz dosage
2mg per 10 kg, starting with 2 mg (0.4 undiluted0 for a 10 kg 1 year old
IV midaz for a 10 kg one year old
1 mg 1 ml (1 mg/ml)
how to draw up IV midaz for a pead
Draw up 1 ml of midazolam from a 15 mg/3 ml ampoule.
Dilute to a total volume of 5 ml using 0.9% sodium chloride.
Discard unrequired drug and administer the volume from the tables as an IV bolus.
10 kg 1 year old paracetamol dose
150 mg 3 ml (50 mg/ml)
predinose dosage per kg
1 ml per kg ( e.g. 10 kg equals 10 mg)
sodium chloride dosege
20 ml/kg
