Pediatrics Flashcards
What are the usual doses of common pain medications in children?
acetaminophen: 12.5 mg/kg
ketorolac: 0.5 mg/kg
fentanyl: 1-2 mcg/kg
morphine: 0.05 mg/kg
What are the usual doses of common induction agents in children?
midazolam: 0.1 mg/kg IV, 1 mg/kg PO
propofol: 2-4 mg/kg
ketamine: 2 mg/kg IV, 4 mg/kg IM
succinylcholine: 1-2 mg/kg IV, 2-4 mg/kg IM
atropine (pre-med): 0.01-0.02 mg/kg IV/IM
What are the usual doses of common ACLS medications in children?
epinephrine: 0.01 mg/kg
atropine: 0.02 mg/kg
What is the most common type of EA/TEF?
a blind esophageal pouch and a fistula linking the distal esophagus to the trachea
What syndrome is associated with EA/TEF?
VACTERL
vertebral anomalies
anal canal defects
cardiac abnormalities
TEF
renal dysplasia
limb defects
What is the risk of placing a gastrostomy in a patient with EA/TEF?
inhaled gas can bypass the lungs and exit through the trachea (especially if lung compliance is poor)
If an infant with EA/TEF cannot be ventilated, what are the salvage options?
emergency ligation through an abdominal or thoracic approach
placement of a ballon catheter through a gastrostmy and inflated to occlude the fistula
What are the options for ETT position during EA/TEF repair?
below the fistula but above the carina
if fistula is small, above the fistula with low ventilation pressures
Where are most congenital diaphragmatic hernias?
85% on the left, through the foramen of Bochdalek
Why are babies with CDH hypoxemic?
less ventilation (low lung compliance)
less surface area for gas exchange (fewer alveoli)
R-to-L shunting through the PDA (pulmonary HTN)
How should a baby with CDH be managed immediately after birth?
NO MASK VENTILATION
intubation
OG tube for stomach decompression
Is CDH a surgical emergency?
no
hemodynamics, respiratory support, and acid/base status should be optimized first
What are the likely causes of abrupt hypotension, hypoxia, and bradycardia after CDH repair?
tension pneumothorax (usually contralateral to the repair)
IVC compression (undersized peritoneal cavity)
Discuss pediatric fluid management.
maintenance fluids: 5% dextrose in 1/2 NS at 4 mL/kg/hr
insensible losses: LR or NS 6-8 mL/kg/hr
blood loss: 3 mL LR or 1 mL albumin/1 mL EBL
What are the components of Tetralogy of Fallot?
RV outflow obstruction
RV hypertrophy
large VSD
overriding aorta
