Pediatric Fluid & Transfusion Management Flashcards
What is the IV fluid bolus dose?
10-20ml/kg bolus
What are the types of fluids administered for deficits and evaporative loss?
balanced salt solutions (LR NS)
When do you add dextrose into IV fluids?
when a patient is at risk for hypoglycemia
D51/2NS
What do you want to be careful of with fluid management?
do not fluid overload
neonatal kidney is unable to excrete large amounts of excess water or electrolytes
volume in extracellular fluid space is larger than adults
What are considerations for PRBCs in pediatrics?
estimate blood volumes
max allowable blood loss
volume of PRBCs to transfuse
always use a filter and warm
citrate preservative
T&S and T&C
indications and special processing
When is fresh frozen plasma administered?
administered to replenish clotting factors lost during massive transfusion
(when EBL exceeds 1-1.5 EBV)
observed coagulopathy or prolongation of PT and PTT and ROTEM
always use a filter and warm
When are platelets administered?
-children whose platelet count has fallen secondary to idiopathic thrombocytopenia purpura or chemotherapy CAN tolerate platelet counts as low as 15,000
-children whose platelet count is decreased b/c of dilution (MTP) generally require transfusions when count is less then 50,000
How are platelets administereD?
through a filter and NOT warmed
What is cell saver?
the salvaging of erythrocytes from suctioned blood
large volumes of washed cells may lead to coagulopathy because of dilution of coagulation factors
Why calcium supplementation?
rapid and multiple transfusions can lead to hypocalcemia
severe ionized hypocalcemia leads to cardiac depression with hypotension
FFP and PRBCs both contain calcium citrate
Describe the neonates calcium supply?
neonates have a decreased ability to mobilize calcium and metabolize citrate
What are irradiated BP?
blood products that are indicated to prevent transfusion related graft vs host disease important in cancer and immunocompromised patients
What are filtered blood products?
blood products are effective way to eliminate the risk of CMV infection and are important for cancer and sickle cell patients
What are washed blood products?
reserved for patient with life threatening allergic reactions and it significantly decreases the lifespan and effectiveness of RBCs in the circulation
What are the recommendations for hyperkalemic cardiac arrest from older blood products?
transfuse before significant hemodynamic compromise
use PIV over CVC and large bore catheters (>23g)
use fresh RBCs and wash RBCs
