Pediatric Protocols Flashcards
According to the Pediatric Pain Management protocol what are the 5 treatment options?
Morphine Sulfate Dilaudid Fentanyl Nitrous Oxide Ketamine
According to the Pediatric Pain Management protocol how many medications may be chosen to treat Pediatric Pain?
ONE
According to the Pediatric Pain Management protocol by what routes can Morphine Sulfate be given?
IV/IO
IM
According to the Pediatric Pain Management protocol what is the IV/IO pediatric dose of Morphine Sulfate?
0.1mg/kg
May repeat every 5 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the IM pediatric dose of Morphine Sulfate?
0.1mg/kg
May repeat every 15 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the blood pressure requirement to give Morphine Sulfate?
SBP>100
According to the Pediatric Pain Management protocol by what routes can Dilaudid be given?
IV/IO
IM
According to the Pediatric Pain Management protocol what is the IV/IO pediatric dose of Dilaudid?
0.015 mg/kg
May repeat every 10 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the IM pediatric dose of Dilaudid?
0.015 mg/kg
May repeat every 15 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the blood pressure requirement to give Dilaudid?
SBP>100
According to the Pediatric Pain Management protocol by what routes can Fentanyl be give?
IV/IO
IN
According to the Pediatric Pain Management protocol what is the IV/IO pediatric dose of Fentanyl?
1mcg/kg
May repeat every 3-5 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the IN pediatric dose of Fentanyl?
2 mcg/kg
May repeat every 3-5 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the blood pressure requiring to give Fentanyl?
SBP>90
According to the Pediatric Pain Management protocol by what route is Nitrous Oxide given?
Inhalation
According to the Pediatric Pain Management protocol what is the pediatric dose of Nitrous Oxide?
Apply and deliver until pt drops mask
According to the Pediatric Pain Management protocol what 2 situations indicate that Ketamine should be considered above other possible pain medications?
If analgesia and axiolytic is needed
Pt is hypotensive
According to the Pediatric Pain Management protocol by what routes can Ketamine be given?
IV/IM/IO/IN
According to the Pediatric Pain Management protocol what is the IV/IM/IO/IN pediatric dose of Ketamine?
0.1-0.5 mg/kg
Max dose 10 mg
May repeat every 10 minutes
Max 3 doses
According to the Pediatric protocols what is the average weight for a preterm infant?
3lbs (1.4kg)
According to the Pediatric protocols what is the estimated ET tube size for a preterm infant?
2.5, 3.0
According to the Pediatric protocols what are the estimated vitals for a preterm infant?
HR 140
RR 40-60
SPB 50-60
According to the Pediatric protocols what is the average weight for a term infant?
7.5lbs (3.4kg)
According to the Pediatric protocols what is the estimated ET tube size for a term infant?
3.5
According to the Pediatric protocols what are the estimated vitals for a term infant?
HR 125
RR 40-60
SBP 60-70
According to the Pediatric protocols what is the average weight for a 6 month old?
15lbs (6.8kg)
According to the Pediatric protocols what is the estimated ET tube size for a 6 month old?
3.5
According to the Pediatric protocols what are the estimated vitals for a 6 month old?
HR 120
RR 24-36
SBP 60-120
According to the Pediatric protocols what is the average weight for a 1 year old?
22lbs (10kg)
According to the Pediatric protocols what is the estimated ET tube size for a 1 year old?
4.0
According to the Pediatric protocols what are the estimated vitals for a 1 year old?
HR 120
RR 22-30
SBP 65-125
According to the Pediatric protocols what is the average weight for a 3 year old?
33lbs (15kg)
According to the Pediatric protocols what is the estimated ET tube size for a 3 year old?
4.5
According to the Pediatric protocols what are the estimated vitals for a 3 year old?
HR 110
RR 20-26
SBP 100
According to the Pediatric protocols what is the average weight for a 6 year old?
44lbs (20kg)
According to the Pediatric protocols what is the estimated ET tube size for a 6 year old?
5.5
According to the Pediatric protocols what are the estimated vitals for a 6 year old?
HR 100
RR 20-24
SBP 100
According to the Pediatric protocols what is the average weight for an 8 year old?
55lbs (25kg)
According to the Pediatric protocols what is the estimated ET tube size for an 8 year old?
6.0
According to the Pediatric protocols what are the estimated vitals for an 8 year old?
HR 90
RR 18-22
SBP 105
According to the Pediatric protocols what is the average weight for a 10 year old?
66lbs (30kg)
According to the Pediatric protocols what is the estimated ET tube size for a 10 year old?
6.5
According to the Pediatric protocols what are the estimated vitals for a 10 year old?
HR 90
RR 18-22
SBP 110
According to the Pediatric protocols what is the average weight for an 11 year old?
77lbs (35kg)
According to the Pediatric protocols what is the estimated ET tube size for an 11 year old?
6.5
According to the Pediatric protocols what are the estimated vitals for an 11 year old?
HR 85
RR 16-22
SBP 110
According to the Pediatric protocols what is the average weight of a 12 year old?
88lbs (40kg)
According to the Pediatric protocols what is the estimated ET tube size for a 12 year old?
7.0
According to the Pediatric protocols what are the estimated vitals for a 12 year old?
HR 85
RR 16-22
SBP 115
According to the Pediatric protocols what is the average weight for a 14 year old?
99lbs (45kg)
According to the Pediatric protocols what is the estimated ET tube size for a 14 year old?
7.0
According to the Pediatric protocols what are the estimated vitals for a 14 year old?
HR 80
RR 14-20
SBP 115
According to the Pediatric Nausea and Vomiting protocol what are your treatment options?
Zofran
Reglan
According to the Pediatric Nausea and vomiting protocol by what routes can Zofran be given?
IV/IM/IN/IO/PO
According to the Pediatric Nausea and vomiting protocol what is the IV/IM/IN/IO/PO pediatric dose of Zofran?
0.1mg/kg
Up to 4mg
According to the Pediatric Nausea and vomiting protocol what treatment option should be considered first line for Nausea?
Zofran
According to the Pediatric Nausea and vomiting protocol by what routes can Reglan be given?
IV/IM/IO
According to the Pediatric Nausea and vomiting protocol what is the IV/IM/IO pediatric dose of Reglan?
0.1mg/kg
Up to 10mg
According to the Pediatric Nausea and vomiting protocol what treatment option should be considered first line for Active Vomiting?
Reglan
According to the Pediatric Nausea and vomiting protocol if after using one treatment option nausea/vomiting symptoms persist what is your next treatment option?
May give a dose of the other agent
According to the Pediatric Nausea and vomiting protocol if after treatment with Reglan the pt develops a dystonic reaction what is your treatment option?
Benadryl
According to the Pediatric Nausea and vomiting protocol by what routes is Benadryl given to treat a dystonic reaction from treatment with Reglan?
IV/IM/IO
According to the Pediatric Nausea and vomiting protocol what is the IV/IM/IO pediatric dose for Benadryl given to terat a dystonic reaction from treatment with Reglan?
1mg/kg
50mg Max
According to the Pediatric Nausea and vomiting protocol what should you consider for pt with prolonged symptoms or signs of dehydration?
IV access
20cc/kg NS fluid bolus
According to the Pediatric Hyperventilation protocol what are 7 possible causes to consider?
- Diabetic Ketoacidosis
- Metabolic acidosis
- Carbon Monoxide
- Pulmonary Embolus
- Pneumothorax
- Aspirin Overdose
- Toxic Alcohol Poisoning
According to the Pediatric Hyperventilation protocol what assessments should be considered?
Pulse oximetry
Capnography
Cardiac monitoring
12 Lead
According to the Pediatric Hyperventilation protocol what should your first course of action be?
Coach respiratory rate and rhythm
According to the Pediatric Hyperventilation protocol how long do you get to see improvement from coached breathing before you need to consider other options?
5 minutes
According to the Pediatric Hyperventilation protocol if after 5 minutes of coached breathing you do not see improvement what are your next 4 courses of action?
- Re-evaluate respiratory function
- Ensure adequate oxygenation (pulse ox)
- Determine blood glucose level
- Establish IV
According to the Pediatric Hyperventilation protocol if the pt is known to be hyperventilating from anxiety what is your treatment option?
Versed
According to the Pediatric Hyperventilation protocol by what routes is Versed given if the pt is known to be hyperventilating from anxiety?
IV/IO
IN
IM
According to the Pediatric Hyperventilation protocol what is the IV/IO pediatric dose of Versed?
0.1mg/kg
Max dose 2.5mg
May repeat every 5 minutes
Max 2 doses
According to the Pediatric Hyperventilation protocol what is the IN pediatric dose of Versed?
0.2mg/kg
Max dose 2.5mg
May repeat every 5 minutes
Max 2 doses
According to the Pediatric Hyperventilation protocol what is the IM pediatric dose of Versed?
0.2mg/kg
Max dose 2.5mg
May repeat every 10-15 minutes
Max 2 doses
According to the Pediatric Altered Mental Status (AMS) protocol what is the acronym to possible causes of AMS?
AEIOUTIPS
According to the Pediatric Altered Mental Status (AMS) protocol what does the acronym AEIOUTIPS stand for?
A-Alcohol E-Endocrine, Electrolyte I-Insulin O-Overdose U-Uremia T-Trauma I-Infections P-Psychiatric S-Stroke
According to the Pediatric Altered Mental Status (AMS) protocol what is your first assessment?
Blood Glucose Level
According to the Pediatric Altered Mental Status (AMS) protocol when should you refer to the Hypoglycemia protocol?
BG < 80
According to the Pediatric Altered Mental Status (AMS) protocol when should you refer to the Hyperglycemia protocol?
BG > 250
According to the Pediatric Altered Mental Status (AMS) protocol after checking the pts blood glucose level what should your next course of action be?
IV access
12 Lead EKG
Capnography
Cardiac monitoring
According to the Pediatric Altered Mental Status (AMS) protocol what treatment option should you consider if the pt has altered mentation with respiratory depression?
Narcan
According to the Pediatric Altered Mental Status (AMS) protocol by what routes can Narcan be given for the pt with altered mentation and respiratory depression?
IV/IM/ET/IO/IN
According to the Pediatric Altered Mental Status (AMS) protocol what is the IV/IM/ET/IO/IN pediatric dose for the pt with altered mentation and respiratory depression?
0.1mg/kg
Up to 2mg
May continue to repeat every 10 minutes if improving
According to the Pediatric Altered Mental Status (AMS) protocol when should RSI be considered?
If gag depressed
GCS<8
Pt deemed unable to protect airway
According to the Pediatric Mild and Moderate Allergic protocol what are the symptoms of a Mild Allergic Reaction?
Rash
Itching
Hives
According to the Pediatric Mild and Moderate Allergic protocol what are the symptoms of a Moderate Allergic Reaction?
Dyspnea/Wheezing
Mild/moderate angioedema
According to the Pediatric Mild and Moderate Allergic protocol what is the treatment option for Mild Allergic Reactions?
Benadryl
According to the Pediatric Mild and Moderate Allergic protocol by what routes can Benadryl be given for a Mild Allergic reaction?
IV/IM/IO
According to the Pediatric Mild and Moderate Allergic protocol what is the IV/IM/IO pediatric dose of Benadryl for a Mild Allergic Reaction?
1mg/kg
25mg Max
According to the Pediatric Mild and Moderate Allergic protocol what is the initial course of treatment for a Moderate Allergic reaction?
IV access
Cardiac Monitoring
Capnography
Consider 20 cc/kg NS fluid bolus
According to the Pediatric Mild and Moderate Allergic protocol what are the treatment options for a Moderate Allergic Reaction?
Benadryl
Albuterol/Atrovent (Duoneb)
Solumedrol
According to the Pediatric Mild and Moderate Allergic protocol by what routes can Benadryl be given for a Moderate Allergic Reaction?
IV/IM/IO
According to the Pediatric Mild and Moderate Allergic protocol what is the IV/IM/IO pediatric dose of Benadryl for a Moderate Allergic Reaction?
1mg/kg
50mg Max
According to the Pediatric Mild and Moderate Allergic protocol what treatment option should be considered if pt presents with wheezing/dyspnea?
Albuterol/Atrovent (Duoneb)
According to the Pediatric Mild and Moderate Allergic protocol by what route is Albuterol/Atrovent (Duoneb) given in the Moderate Allergic Reaction with wheezing/dyspnea?
Nebulized
According to the Pediatric Mild and Moderate Allergic protocol what is the pediatric dose for Albuterol/Atrovent (Duoneb)?
Albuterol 2.5mg with Atrovent 500mcg (Duoneb)
May repeat 2 times
According to the Pediatric Mild and Moderate Allergic protocol if a pt is <1 and has a Moderate Allergic Reaction with wheezing/dyspnea what is the dose of Albuterol/Atrovent (Duoneb)?
Half dose of Albuterol/Atrovent (Duoneb)
According to the Pediatric Mild and Moderate Allergic protocol by what routes can Solumedrol be given?
IV/IO/IM
According to the Pediatric Mild and Moderate Allergic protocol what is the IV/IO/IM pediatric dose for Solumedrol?
2mg/kg
125mg Max
According to the Pediatric Mild and Moderate Allergic protocol if the pt does not improve despite treatments what is your next course of action?
Proceed to Pediatric Severe Allergic Reaction Protocol
According to the Pediatric Severe Allergic Reaction protocol what are the symptoms of a Severe Allergic Reaction?
Severe dyspnea
Severe angioedema
Hypotension
Altered mental status
According to the Pediatric Severe Allergic Reaction protocol what should you consider early in your treatment plan?
Early airway intervention
(RSI?)
(Surgical airway?)
According to the Pediatric Severe Allergic Reaction protocol what is you initial course of action?
IV access
Capnography
Cardiac monitoring
Consider 2nd IV
According to the Pediatric Severe Allergic Reaction protocol what are your treatment options for upper airway involvement and/or stridor?
Racemic Epinephrine
Epinephrine 1:1,000
Pediatric Epinephrine Pen
According to the Pediatric Severe Allergic Reaction protocol what is your pediatric dose of Racemic Epinephrine if your pt is <4 years old?
- 05 ml/kg
0. 5 ml Max
According to the Pediatric Severe Allergic Reaction protocol what is your pediatric dose of Racemic Epinephrine if your pt is >4 years old?
0.5 ml
According to the Pediatric Severe Allergic Reaction protocol by what route can Epinephrine 1:1,000 be given for upper airway involvement and/or stridor?
IM
According to the Pediatric Severe Allergic Reaction protocol what is the IM pediatric dose of Epinephrine 1:1,000?
0.01 mg/kg
0.3 Max
May repeat every 5-10 minutes if needed
According to the Pediatric Severe Allergic Reaction protocol how do you calculate the appropriate SBP for a pediatric pt?
70 + 2(Age)
According to the Pediatric Severe Allergic Reaction protocol what is the treatment option for a hypotensive pt?
20 cc/kg NS fluid bolus
According to the Pediatric Severe Allergic Reaction protocol what are your treatment options?
Benadryl
Albuterol/ Atrovent (Duoneb)
Solumedrol
According to the Pediatric Severe Allergic Reaction protocol what is your treatment option if pt remains hypotensive despite fluid bolus?
Epinephrine Push Dose Presser
According to the Pediatric Severe Allergic Reaction protocol by what route is the Epinephrine Push Dose Presser given to the hypotensive pt not responsive to a fluid bolus?
IV
According to the Pediatric Severe Allergic Reaction protocol what is the IV pediatric dose of the Epinephrine Push Dose Presser given to the hypotensive pt not responsive to a fluid bolus?
0.5-2ml every 2-5 minutes for SBP < [70 + 2(Age)]
According to the Pediatric Severe Allergic Reaction protocol if no improvement after treatments why should intubation be considered early?
Early intubation is paramount as laryngeal edema and spasm can progress rapidly
According to the Pediatric Diabetic Emergencies-Hyperglycemia protocol what is the criteria for Pediatric Hyperglycemia?
BG>250 mg/dcl
According to the Pediatric Diabetic Emergencies-Hyperglycemia protocol what is your initial course of action for the Pediatric Hyperglycemia pt?
IV access
Consider capnography
NS fluid bolus 20 cc/kg and repeat to maintain SBP> 70 + 2(Age)
According to the Pediatric Diabetic Emergencies-Hyperglycemia protocol what are 5 pertinent histories to obtain?
Diabetic? If so...taking medications/insulin? Fever? Nausea/ Vomiting? Polydipsia? Polyuria?