Peds Flashcards
neonate
0-28 days
infant
28 days-1 year
toddler
12-24 months
young child
2-12 years
older child
12-18 years
lung development: 4 weeks
lungs start to form
when do lung start producing surfactant
24 weeks
when do mature alveoli form
36 weeks
when do most alveoli form
postnatally
pediatrics have more _________ rib angle
horizontal
peds breathing is __________ driven
diaphragmatically
ped ribcage has _______ compliance
high compliance
why do peds have smaller tidal volumes
due to diaphragmatic breathing
25% type 1 fibers
FRC is _____ in peds
decreased
peds have a _______ apneic threshold
very short apeneic threshold
neonates O2 consumption
6-8ml/kg/min
infant O2 consumption
3-4 ml?kg/min
closing capacity in infants is _____ than FRC
CC > FRC
when CC approaches FRC, what happens
small airway starts to collapse
neonate breathing pattern
periodic breathing
what is common post op in premature pts
apnea
neonatal myocardium has __________ myocytes
poorly organized myocytes
peds SV
fixed
peds CO is dependent on
HR
when is the sympathetic nervous system fully developed
4-6 months
peds have an exaggerated
vagal response
prone to bradycardia
what do you give peds before DL
atropine
as pts get older, HR ______
decreases
as pts get older, systolic pressure ____
increases
as pts get older, RR
decreases
what replaces the placenta after birth
kidneys
GFR at birth
15-30%
GFR 5-10 day old
50%
when does renal function approach normal
6 months
what drug can you not give to peds under 6 months?
NSAIDs
toradol
blood volume is ______ in youngest pts
higher
blood volume in ________ to age
inversely proportional
Hg before birth
HgF
Hg after birht
HGA
Hg at birth rate
14-20 g/dl
HgF = 70-80%
Nadir occurs
9-12 weeks
Nadir Hg
10-12 g/dL
Nadir occurs when
loss of HgF but have not made enough HgA
Nadir causes ______ shift of the oxy-hb curve
right shift due to 2,3 DPG
Nadir compensatory mech
increase 2,3-DPG
peds inhalational induction
faster than adults
infants MV:FRC ration
5:1
adults MV:FRC ration
1.5:1
what pts need the highest MAC values
infants 0-6months
what fluids should peds get in OR
isotonic to avoid hyponatremia/K+ disturbances
what crystalloids should you give peds
LR
plasmalyte
what colloids should you give peds
albumin
when do we give glucose to peds
<6 mos
<5kg
why do we give glucose to peds
pts are NPO
high metabolism makes diagnosis difficult
peds have _________ occiput
larger occiput
peds have _________ tongue
larger tongue
what is the narrowest part of peds airway
cricoid
(cords)
where is the larynx in peds
C3-4
what shape is a peds epiglottis
omega
neonate-12 mo mask size
2
1-4 year mask size
3
4-12 year mask sizde
4
12+ year mask size
5
err on the __________ size for mask
larger
peds uncuffed ETT
age/4 +4
peds cuffed ETT
uncuffed-0.5
peds ETT depth
3*internal diameter of tube
LMA has ______ airway complications vs ETT in peds
lower
<5 kg
LMA 1
5-10kg
LMA 1.5
10-20kg
LMA2
20-30kg
LMA2.5
30-50kg
LMA 3
50-70kg
LMA4
peds IBW
IBW = 2*age+10
peds lose heat more ________ than adults
more rapidly
how do infants thermoregulate
non-shivering thermogenesis
brown fat metabolism
when do kids start expericinge PONV
2 years
what peds sx have higher PONV risk
tonsils
ears
eyes
gonadal
cleft palate
dental
lap
how to treat PACU stridor
dexamethasone
racemic epi
PONV treatment
dexamethasone
zofran
benadryl
emergence agitation treatment
demedetomidine (0.5-1mcg/kg) at extubation
