Peds

Question 1

What gauge needle is used in peds?

Answer 1

22g

Question 2

What is the 4/2/1 rule?

Answer 2

4ml/kg kg’s 1-10, 2ml/kg kg’s 11-20, 1ml/kg kg’s 21+

Question 3

What is the equation for determining pedi ETT size?

Answer 3

age/4 + 4

-1/2 for cuffed

Question 4

To what pressure should a pedi ETT cuff be inflated?

Answer 4

20cmH2O

Question 5

Which ventilation mode is typically used in peds?

Answer 5

pressure support

Question 6

What is the typical mix of air and O2 in peds?

Answer 6

2L air / 1L O2

Question 7

How does a pediatric patient react to sympathomimetics as compared an adult?

Answer 7

Peds sympathetic system is immature and has a lesser response to the drugs

Question 8

Dead space per kg is lesser/greater in peds?

Answer 8

greater

Question 9

Lung/chest wall compliance is lesser/greater in peds

Answer 9

lesser

Question 10

FRC per kg is lesser/greater in peds?

Answer 10

lesser

Question 11

TV per kg is lesser/greater in peds?

Answer 11

greater

Question 12

Why are peds more prone to bradycardia?

Answer 12

their SNS is immature and PNS is prone to dominance

Question 13

When should the PDA close?

Answer 13

functionally by 1 week and anatomically by 3 weeks

Question 14

Body surface area to mass ratio is lesser/greater in peds?

Answer 14

greater

Question 15

Renal function should be normal by _____.

Answer 15

6-12mo

Question 16

Regarding the poor renal function of premies, which electrolytes are retained more?

Answer 16

creatinine, glucose

Question 17

Regarding the poor renal function of premies, which electrolytes are excreted more?

Answer 17

Na+, bicarb

Question 18

How is hypoglycemia defined in neonates? Older children?

Answer 18

<40mg/dL

Question 19

Why are peds at increased risk for reflux/aspiration?

Answer 19

they have prolonged gastric emptying and incompetent LES

Question 20

The immature CNS of peds predisposes them to what?

Answer 20

seizure, respiratory depression, retinopathy, intraventricular hemorrhage

Question 21

Why do infants require larger doses of sux?

Answer 21

they have a larger relative volume of distribution

Question 22

The pedi larynx corresponds with what vertebra?

Answer 22

C3-4 (vs C5-6 in adults)

Question 23

The narrowest part of the pedi airway is the _______.

Answer 23

cricoid cartilage

Question 24

How do patients <6mo breath?

Answer 24

nasally

Question 25

EBL for premies? full-term? up to 1 yr?

Answer 25

95ml/kg; 85ml/kg; 80ml/kg

Question 26

Incidence of asthma in peds is _____.

Answer 26

7-19%

Question 27

Prematurity is defined as what gestational age?

Answer 27

before 37 weeks

Question 28

High FiO2 in premies can cause what?

Answer 28

retinopathy

Question 29

What joint is unstable in Down’s Syndrome patients?

Answer 29

atlanto-occipital

Question 30

What is a sedating dose of midazolam for peds?

Answer 30

0.1mg/kg IV or 0.5mg/kg PO

Question 31

What is a sedating dose of ketamine for peds?

Answer 31

0.2-0.8mg/kg IV or 2-4mg/kg IM

Question 32

What is an induction dose of ketamine for peds?

Answer 32

1-2mg/kg IV or 4-8mg/kg IM

Question 33

Why is mask induction dangerous?

Answer 33

because there is generally no IV access to give drugs if needed

Question 34

Veins in children are more superficial/deep in children?

Answer 34

superficial

Question 35

In otherwise healthy kids, what are the two most important things to ask about preoperatively?

Answer 35

NPO status and recent cough/cold

Question 36

What is an induction concern if a child has a cough?

Answer 36

can cause laryngospasm with mask induction

Question 37

The glottis in children is more anterior/posterior?

Answer 37

anterior

Question 38

What is “brutane?” When is it used?

Answer 38

8% sevo + 60% N2O; for mask induction of highly anxious patients