Peds Flashcards
What gauge needle is used in peds?
22g
What is the 4/2/1 rule?
4ml/kg kg’s 1-10, 2ml/kg kg’s 11-20, 1ml/kg kg’s 21+
What is the equation for determining pedi ETT size?
age/4 + 4
-1/2 for cuffed
To what pressure should a pedi ETT cuff be inflated?
20cmH2O
Which ventilation mode is typically used in peds?
pressure support
What is the typical mix of air and O2 in peds?
2L air / 1L O2
How does a pediatric patient react to sympathomimetics as compared an adult?
Peds sympathetic system is immature and has a lesser response to the drugs
Dead space per kg is lesser/greater in peds?
greater
Lung/chest wall compliance is lesser/greater in peds
lesser
FRC per kg is lesser/greater in peds?
lesser
TV per kg is lesser/greater in peds?
greater
Why are peds more prone to bradycardia?
their SNS is immature and PNS is prone to dominance
When should the PDA close?
functionally by 1 week and anatomically by 3 weeks
Body surface area to mass ratio is lesser/greater in peds?
greater
Renal function should be normal by _____.
6-12mo
Regarding the poor renal function of premies, which electrolytes are retained more?
creatinine, glucose
Regarding the poor renal function of premies, which electrolytes are excreted more?
Na+, bicarb
How is hypoglycemia defined in neonates? Older children?
<40mg/dL
Why are peds at increased risk for reflux/aspiration?
they have prolonged gastric emptying and incompetent LES
The immature CNS of peds predisposes them to what?
seizure, respiratory depression, retinopathy, intraventricular hemorrhage
Why do infants require larger doses of sux?
they have a larger relative volume of distribution
The pedi larynx corresponds with what vertebra?
C3-4 (vs C5-6 in adults)
The narrowest part of the pedi airway is the _______.
cricoid cartilage
How do patients <6mo breath?
nasally
EBL for premies? full-term? up to 1 yr?
95ml/kg; 85ml/kg; 80ml/kg
Incidence of asthma in peds is _____.
7-19%
Prematurity is defined as what gestational age?
before 37 weeks
High FiO2 in premies can cause what?
retinopathy
What joint is unstable in Down’s Syndrome patients?
atlanto-occipital
What is a sedating dose of midazolam for peds?
0.1mg/kg IV or 0.5mg/kg PO
What is a sedating dose of ketamine for peds?
0.2-0.8mg/kg IV or 2-4mg/kg IM
What is an induction dose of ketamine for peds?
1-2mg/kg IV or 4-8mg/kg IM
Why is mask induction dangerous?
because there is generally no IV access to give drugs if needed
Veins in children are more superficial/deep in children?
superficial
In otherwise healthy kids, what are the two most important things to ask about preoperatively?
NPO status and recent cough/cold
What is an induction concern if a child has a cough?
can cause laryngospasm with mask induction
The glottis in children is more anterior/posterior?
anterior
What is “brutane?” When is it used?
8% sevo + 60% N2O; for mask induction of highly anxious patients
