PEDS Flashcards
Peds ventilator compliance
1 ml/cmh20/ kg
Peds tube length (depth)
tube size x 3
Peds ett size > 2yrs
(Age/ 4) + 4 = uncuffed
(Age / 4) + 3 = cuffed
Premies < 1 kg ett size
2.5
Premies 1-2.5 kg ett size
3
Term neonates (6 mo) ett size (2.5-3 kg)
3.0-3.5
6 mo - 1 yr ett suze
3.5-4.0
1-2 yo ett size
4-4.5
EBV for premature infant
95 ml/kg
EBV for full term infant
85 ml /kg
Infant to 12 mo EBV
80 ml/kg
male child EBV
75ml/kg
female child EBV
65 ml/kg
Peds up to 5 kg LMA size and max cuff volume
size 1 up to 4 ml of air
Peds 5-10 kg LMA size and max cuff volume
size 1.5 up to 7 ml of air
Peds 10-20 kg LMA size and max cuff volume
size 2 up to 10 ml of air
Peds 20-30 kg LMA size and max cuff volume
size 2.5 up to 14 ml of air
Peds >30 kg LMA size and max cuff volume
size 3 up to 20 ml of air
peds atropine dose
0.02 mg/kg IV or IM
may double amount on second dose
ET - 0.03 mg/kg
child max - 1 mg
adolescent max = 2 mg
peds Epinephrine dose
0.01 mg/kg
5-10 mcg/kg
ETT dose is 10 x the IV dose . follow with 1-5 ml flush
gtt; 0.01-4 mcg/kg/min
succinylcholine dose peds
1 -2 mg /kg IV
2-4 mg/kg IM
When to use a peds circuit?
< 50 kg
reservoir bag
1L = 6 mon - 6 yrs < 25 kg
2L = 30-50 kg
3L > 50 kg
Peds VT
6-8 ml/kg
Ancef peds dose
25 mg/kg
ROC (zemuron) peds dose
< 1yo 0.25-0.5 mg/kg
1 yo 0.5-1.2 mg/kg
> 1 yo 1-1.3 mg/kg
IM 1-1.8 mg.kg
onset 90-120 sec
renal 30%, hepatic 70%
25% for maint dose
What does high FiO2 cause in peds
< 1250 gram or less than and < 31 weeks gestation are at highest risk for retinopathy of prematurity ( ROP) with high leves of O2
VEC norcuron dose PEDS
< 1 yo 0.05-0.1mg/kg
> 1 yo 0.1 mg/kg
onset 2-3 min renal 30%, hepatic 70%
25% for maint dose
Propofol induction dose for peds
2.5-3.5 mg /kg
emergency = 0.5mg/kg
gtt; 50-200 mcg/kg/min
Etomidate peds dose
0.3-0.4 mg/kg
Ketamine IV dose peds
1-2 mg/kg
Peds Ketamine IM dose
5-10 mg/kg
Peds Ketamine intranasal dose
0.15-0.3mg/kg
Nimbex beds dose peds
0.1-0.2 mg/kg
Robinul peds dose
0.01 mg/kg
or 5-10 mcg/kg
Neostigmine peds dose
0.05-0.07 mg/kg
Fentanyl peds dose
1-2mcg/kg IV
intranasal (1ml/nare) 2 mcg/kg
2-10 mcg/kg. hearts = 50 mcg/kg
Morphine peds doses IV and IM
0.05-0.1 mg/kg IV
0.1-0.15 mg/kg IM
Demerol peds dose
1-2 mg/kg
Dilaudid peds dose
0.015 mg/kg
< 20 kg not recommedned
Sufentanyl peds dose intransasal and IV
Intranasal 0.25–0.5 mcg/kg
IV = 0.2-0.6 mcg/kg
Remifent peds dose IV and GTT
0.5-1 mcg/kg
gtt 0.05-1.3mcg/kg/min
Narcan peds dose
0.01 mg/kg
nubain dose
0.1-0.2 mg/kg
Tylenol Peds dose, IV, Rectal/PO
10-15 mg/kg IV (safety and efficacy not esablished < 2 yo)
Rectal/PO; (10-40mg/kg)
3 mo - 3 yr=80 mg
3-6 yr = 120 mg
6-12 yr = 325 mg
> 12 yo = 325-650 mg
max = 4 grams in 24 hrs
Toradol Peds dose
0.5 mg/kg IV / IM
safety and efficacy not established < 2 yo
Precedex peds dose, intranasal, IV loading dose, emergence, gtt
Intransasal 2 mcg/kg
loading dose - 1 mcg/kg over 10 min
emergence 0.5 mcg/kg
gtt; 0.1-0.7 mcg/kg/hr
Ibuprofen (caldor) peds dose
10 mg/kg
daily max dose = 40 mg/kg or 2.4 grams whichever is less
not approved for < 6 mo
Versed Peds dose
0.05-0.15 mg/kg IV (0-6 months)
0.3-0.5 mg/kg Nasal
0.5-0.7 mg/kg PO up to 15 mg
Ativan peds dose
0.05 mg/kg
status epilepticus 0.05-0.1 mg/kg
Peds valium dose
0.1-0.2 mg/kg
status; 0.2-0.3 mg/kg
Romazicon peds dose
0.02-0.03 mg/kg reversal
max 0.1mg/kg
Crystalloid bolus for peds mild hypotension
< 10 kg = 5-10 ml/kg
> 10 kg = 20 ml/kg
Crystalloid bolus for peds severe hypotension
20-50 ml/kg
Albumin bolus for peds mild hypotension
< 10 kg = 5-10 ml/kg
> 10 kg = 20 ml /kg
Albumin bolus dose for peds severe hypotesnion
20-50 ml/kg
Peds blood bolus
10-20 ml/kg
anzemet peds dose
0.35 mg/kg up to 12.5 mg
Zofran peds dose
0.1 mg/kg
Reglan peds dose
0.1mg/kg
Decadron peds dose
0.2-1 mg/kg
max dose = 20 mg
Pepcid peds dose
0.5 mg/kg
solucortef (hydrocortizone) peds dose
1-2 mg/kg
zantac peds dose
0.5-1 mg/kg
Solumedrol peds dose
1-2 mg/kg max is 125 mg
Phenergean peds dose
0.5-1 mg/kg
dont exceed 25 mg
scopalamine peds dose
6 mcg/kg
Esmolol peds dose IV and gtt
0.1-0.5 mg/kg
gtt 50-100 mcg/kg / min
Hydralazine peds dose
0.15-0.3 mg/kg
Isopreterenol peds dose gtt
0.1-2.0 mcg/kg/min
mannitol peds dose
0.25-1 grams/kg
lidocaine peds dose
1 mg/ kg
max = 3mg/kg
Vasopressin peds dose
< 1 yo 0.1-0.2 units/kg
1-15 yo 0.1-0.3 units/kg
Dantrolene meds dose
2.5 mg/kg q 5 min up to 30 mg/kg
ryanodex = same dose but its more concentrated
Albuterol peds dose
MDI = multiple puffs
nebulizer 0.1-0.15 mg/kg
status asthematicus = 0.02-0.03 ml/kg of 5 mg/ml solution with nss to make 3 ml total in nebulizer. max dose is 2.5 mg
Benedryl peds dose
0.5-2 mg/kg
CaCL10% peds dose
20 mg/kg
dont bolus. for hypocalcemia, hypermagnzemia and ca channel blocker toxicity
Ca Gluconate peds dose
30 mg/kg- 50 mg/kg
Ephedrine peds dose
0.2-0.3 mg/kg
adenosine peds dose
0.1mg/kg
if second dose is needed administer 2 x the initial dose
Amiodarone peds dose
5 mg/kg
bolus over 20 min for SVT
Magnesium peds dose
25-50 mg/kg
milrinone peds dose bolus and gtt
50-75 mcg/kg loading dose
gtt= 0.25-0.75 mcg/kg/min
furosemide peds dose
1 mg/kg
Phenylephrine peds dose
2-5 mcg/kg
0.1-0.7mcg/kg/min
safety and efficacy not established
Defibillation peds dose
2 joules/kg initial
if repeated 4 joules/kg
Cardioversion peds dose
A flutter 0.5 joules/kg
a fib 1 joule/kg
When is the sympathetic nervous system fully developed
4-6 months
infants and newborns are prone to bradycardia with what?
Hypoxia
hypovolemia
laryngoscopy
pharyngeal suctioning
Weight thats considered low birth weight
<1500 grams
1 lb is how many grams
454 grams
2 lbs is how many grams
908 grams
3 lbs is how many grams
1363 grams
4 lbs is how many grams
1818 grams
Birth weight doubles by _____ triples by ____
Birth weight doubles by 6 months triples by 1 year
by 4 yrs the average wt is 18 kg and 40 inches long
Resting stroke volume in neonate
1 ml/kg/min
SV is constant due to LV being non compliant because myocardium is not fully developed. and poorly developed
CO at birth and adolesency
CO at birth = 200 ml/kg/min
CO at adolescence - 100 ml/kg/min
PEDS EKG changes
right sided predominancy of the fetal heart so the neonate has a R axis deviation
Right leads have tall R waves
Deep S waves in the Left leads
SHort qrs duration
T waves intervets to the left
Neonate normal HR
150 bpm
Term neonate cerebral blood flow
42-48 ml/ 100 grams/ min
4-6 months cerebral blood flow
90-100ml/100 grams/ min
3-4 years old cerebral blood flow
110ml/100 grams/min
9 years old cerebral blood flow
78 mls/ 100 grams/ min
1 lb is how many grams
453 grams
Normal ICP in neonates
2-4 mmhg
Where does the spinal cord end at birth
L3 and is normal by the age of 8 yes
HCO3 replacement dose
0.2 x weight (kg) x base deficit
1 meq/kg
for metabolic acidosis and TCA OD
use 0.5 meq/ml conc in neonates.
Dopamine peds dose
3-20mcg/kg/min
Dobutamine peds dose
2.5-20 mcg/kg/min
Peds O2 consumption
6-7ml/kg/min
FRC peds
27-30 ml /kg
Oxy hbg curve shift with peds
left shift because incrased fetal hbg afifnity and decreased DPG
Preterm Heart rate, sbp, RR
HR = 120-200 bpm
SBP= 40-60
RR= 55-60
map = gestational age in weeks
Newborn HR, SBP, RR
HR= 100-150
SBP= 50-75
RR = 35-40
6 month HR,SBP,RR
HR = 110-150
SBP= 60-110
RR- 25-30
1-2 yrs HR, SBP, RR
HR= 100-130
SBP= 65-115
RR= 20-24
2-3 yrs HR,SBP,RR
HR= 90-125
SBP = 75-125
RR= 16-22
3-5 yrs HR, SBP,RR
HR= 80-135
SBP= 80-120
RR = 14-20
5-8 yrs HR, SBP, RR
HR= 80-115
SBP= 90-120
RR = 12-20
9-12 yrs HR,SBP, RR
HR = 70-110
SBP = 90-130
RR= 12-20
12-14 yrs HR, SBP, RR
HR = 65-115
SBP= 110-140
RR = 10-14
Room temps based on age
Newborns—-80
1-6 months–78
6mo-2 years-76
Over 2 years-74
NPO times PEDS
Clear liquids —- 2 hours
Breast milk —- 4 hours
Infant formula– 6 hours
Non-human milk 6 hours
Light meal —— 6 hours
Meal with fat—- 8 hours
Difference between formula and breast milk
breast milk = fat
formula = particulate matter = like a solid but not quiet
Sevo MAC for 0-1 month
3.3%
Sevo MAC 1-5 months
3%
Sevo MAC 6 months - 3 yrs
2.8%
SEVO MAC 3-12 yrs
2.5%
PEDs TXA dose
loading dose 10 mg/kg over 30 min then gtt 1 mg/kg/hr
Heparin peds dose
1-3 mg/kg IV or 100-300 units/kg
Protamine peds dose
3-5 mg/kg SLOW IV
nitroglycerine peds dose
0.5-5 mcg/kg/min
SNP peds dose
0.05-5 mcg/kg/min
Diltiazem (cardizem) peds dose bolus and gtt
0.25 mg/kg over 2 min
gtt = 4-15 mg/hr
