Pediatric SO Flashcards
Pedi Allergic Reaction w/out Shock
- O2 via NRM
- Epi 1:1k IM 0.01 mg/kg (max 0.3 mg/30 kg)
- Wheezing, go to Pedi Bronchospasm, and then Albuterol 2.5 mg neb
- IV @ TKO
- Benadryl 1 mg/kg IV (max 25 mg/25 kg), give IM if no IV
- S/S persist, give Solu-Medrol 2 mg/kg (125 mg max/62.5 kg)
Pedi Allergic Reaction w/ Shock
- O2 via NRM
- Epi 1:1k IM 0.01 mg/kg (max 0.3 mg/30 kg)
- IV w/ 20 cc/kg bolus
- start IO if critical pt w/ out IV
- Epi 1:10k IV 0.01 mg/kg over 1-2 mins
- Benadryl 1 mg/kg IV (max 25 mg/25 kg), give IM if no IV
- Solu-Medrol 2 mg/kg (125 mg max/62.5 kg)
- Wheezing, go to Pedi Bronchospasm, and then Albuterol 2.5 mg neb
- if S/S continue: repeat 1:1k Epi IM (0.01 mg/kg) and NS bolus (20 cc/kg)
Pedi Bradycardia (indications)
60> BPM w/ poor perfusion
Pedi Bradycardia
- Assist respirations w/ BPM
- Intubate
- if Poor perfusion, start CPR
- IV/IO (one leg only)
- Epi 1:10k 0.01 mg/kg (or 1:1k Epi 0.01 mg/kg via ET) every 3-5 mins
- NS bolus 20 cc/kg
- if increased vagal tone is possible or AV block is present, IV Atropine 0.02 mg/kg, may repeat (min dose: 0.1 mg/5kg | Max dose: 1mg/50 kg)
- Apply pacemaker pads and ONLY turn on w/ BSP commo
Pedi Bronchospasm (indications)
Respiratory distress w/ wheezing not involving foreign body airway obstruction
Pedi Bronchospasm
- O2 via NRM
- Severe respiratory distress: EPI 1:1k 0.01 mg/kg (0.3 mg/30 kg max)
- 2.5 mg Albuterol neb, if severe, front load 5 mg Albuterol and 0.5 mg Atrovent
- if S/S persist, 2nd 2.5 mg Albuterol with 0.5 mg Atrovent (if not given already)
- Intubated pt w/ poor compliance due to bronchospasm: 1:10k EPI 0.01 mg/kg via ET
Pedi Hypoglycemia
Check BGL and IF 70> mg/dl:
- pt alert and able to swallow/maintain airway, give 1g/kg oral glucose PO (50g/50kg max)
or
- pt unable to swallow/unconscious give appropriate IV dextrose (D10/D25/D50) to Newborn/Infant 30> kg/Pedi >30 kg
- If no IV unavailable, give 1 mg glucagon IM or if 1 y/o > 0.5 mg IM
Recheck BGL
Pedi Hypoglycemia D10/Newborn Dose
0.2 g/kg
4 parts NS 1 part D50 = D10
2 cc/kg of D10
Pedi Hypoglycemia D25/Infant 30> kg Dose
0.5 g/kg
1 part NS 1 part D50 = D25
2 cc/kg of D25
Pedi Hypoglycemia D50/Pedi >30 kg Dose
0.5 g/kg (25g/50 kg max)
2 cc/kg of D50
Pediatric (definition)
- 13> y/o
- IF >8 y/o size/age or size of small adult, use adult SO not covered in pedi SO
Pedi Hypovolemia
S/S secondary to hypovolemia
- O2 via NRM or intubate
- IV or IO if pt critical and give 20 cc/kg bolus
- repeat 20 cc/kg bolus as needed while enroute
- Hemorrhagic shock due to trauma, 10 cc/kg bolus and reassess. NO 2nd bolus w/out commo to BSP
- keep pt warm and cover wounds
Pedi Cardiac Arrest
- if no pulse or BP
- CPR/BVM 15:2
- EKG
- CPR for 2 mins prior to defib if in vtac/vfib unless good CPR done
Pedi Cardiac Arrest - Asystole
- CPR
- ET
- IV/IO
- Epi 1:10k 0.01 mg/kg IV/IO or (0.1 mg/kg 1:1k via ET) every 3-5 mins
Pedi Cardiac Arrest - PEA
- CPR
- ET
- IV/IO (leg only)
- Epi 1:10k 0.01 mg/kg IV or (0.1 mg/kg Epi 1:1k ET) every 3-5 mins
- NS bolus 20 cc/kg IV
- assess for reasons of PEA (H&T’s)
Pedi Cardiac Arrest - Vfib/Vtac
- Defib 2J/kg (CPR prior to shock) (#1)
- CPR 2 mins with IV/IO
- Pulse/EKG check after 2 mins
- if VF/pulseless VT, epi 1:10k 0.01 mg/kg via IV/IO (or Epi 1:1k 0.1 mg/kg ET)
- if Torsades, give 25 mg/kg (max 2g/80kg)
- Defib 4J/kg (#2)
- CPR 2 mins then pulse/rhythm check
- VF/VT still, Amiodarone 5 mg/kg or Lido 1 mg/kg (if no Amio)
- Defib 4 J/kg (#3)
- CPR 2 mins then pulse/rhythm check
Pedi Respiratory Arrest
with pulse:
- O2 via BVM
- ET, but if no ET, BVM
- IV @TKO
Pedi Near Drowning
If pulse absent, begin CPR and go to Arrest SO
If pulse present:
- O2 via NRM
- if still in distress, CPAP
- Contraindications (BP 90>, Awake/follows, Mask fits, maintain airway)
- IV @ TKO
- keep warm
- Como of CPAP use and revert to BVM if deteriorates
Pedi Drug OD
- Check airway O2 as needed
- EKG
- IV @ TKO
- if no gag, L lateral recumbent position and suction/manage airway PRN
- bring in bottles/containers
Pedi Newborn Resus (indications)
- HR 100>/min
- poor respirations
- cyanotic and limp
Pedi Newborn Resus
- Warm, dry, suction (only if meconium in mouth), stimulate and evaluate APGAR
- BVM 2:3 secs, use room air then 100% as needed
- if HR 60 >, BVM or ET 3.5 full (3.0 premature 2-3 kg, 2.5 if 2> kg)
- if HR still 60 >, CPR 120/mins, 3:1
- Epi 1:10k 0.03 mg/kg IV or 1:10k 0.1 mg/kg w/ 2 cc NS every 3-5 mins
Pedi Sz (indications)
- continuous generalized sz or repeated sz w/out return to consciousness
Pedi Sz
- O2 via NRM/BVM
- BGL check, and follow SO if indicated
- if Sz >5 mins
- Versed 0.2 mg/kg IN/IM
- IV @ TKO
- if no versed: 0.1 mg valium IV (5 mg/50 kg max) or 0.5 mg/kg rectally (10 mg/50 kg max)
- Valium unavailable, sub w/ lorazepam 0.1 mg/kg (2 mg/20 kg max)
- EKG/monitor as needed, refrain from ET
Pedi Tachycardia
If pulses and poor/inadequate perfusion
- O2
- 12 lead
- como
