peds Flashcards
Why is intussusception rare before 3m?
passive immunity is still high in first 3m of life, and most intussusception in kids is 2/2 hypertrophic lymphoid tissue following an infection
initial fluid bolus in pediatric DKA
10 cc/kg over 1h
Fentanyl dosing (IV and IN)
IV: 0.5-1 mcg/kg (max 50 mcg)
IN: 1-2 mcg/kg
…so basically, 1 mcg/kg but can upgrade it for IN
morphine dosing and routes
0.05-0.1 mg/kg (max 5 mg IV)
IV, IM, or SC
Narcan dosing (IV and IN)
IV: 0.01 mg/kg
IN: 0.1 mg/kg
adolescents: 2 mg/dose
repeat q2-3m
APAP dosing and max
15 mg/kg (max 1 g)
oxycodone dosing
0.05-0.15 mg/kg
how long does LMX take to work
20m
ketamine sub-dissociative dosing
<0.3 mg/kg
important thing to monitor during neonatal sedation
glucose
Versed dosing (IV, IN, and PO)
IV: 0.05-0.1 mg/kg (max 2 mg)
IN: 0.2-0.3 mg/kg (max 5 mg)
PO: 0.5-0.7 mg/kg, max 15 mg
flumazenil dosing
0.01 mg/kg (max 0.2 mg) over 15s
repeat: same dose after 45s
may keep repeating every min to max 0.05 mg/kg or 1 mg (whichever is lower)
ketamine sedative dosing
1 mg/kg IV, repeated q20-30m, to max 3 mg/kg
propofol dosing (push and gtt)
0.5 mg/kg IV (max 2 mg/kg)
gtt 25-75 mcg/kg/min
Precedex dosing and contraindications
1-2 mcg/kg IV over 10m > gtt at 0.2-1 mcg/kg/hr
careful: bradycardia, AV block, dig
NPO guidelines
clears: 2h
breastmilk: 4h
formula and solids: 6h
neonatal ETT sizing: < 28 wks, 28-34 wks, 34-38 wks, > 38 wks
< 28 wks: 2.5
28-34 wks: 3
34-38 wks: 3.5
> 38 wks: 3.5-4
neonatal ETT depth
6 + weight (kg)
peds ETT sizing
uncuffed = 4 + age/4 cuffed = 3.5 + age/4
definition of a UTI on cath
> 50,000 CFU of a single organism
infant UTI organism
GBS
> 1y old UTI organism
E. coli
malrotation age group
within 1y of life
intussusception age group
3m-5y
HUS
E. coli bloody diarrhea w/ART: anemia, renal failure, thrombocytopenia
- NO ABX
croup: who gets dex, who gets racemic epi
dex 0.6 mg/kg for all (PO is fine)
racemic epi for stridor at rest or significant respiratory distress (observe x 3h post since sx may recur - then, admit)
differentiating bacterial tracheitis from croup
tracheitis pts look toxic, are older (3-5y), and don’t respond to croup tx
Salter-Harris classification
S-A-L-T-ER
1 = slipped (separated through growth plate, think SCFE) 2 = above growth plate 3 = lower than growth plate 4 = through growth plate 5 = erasure of growth plate (crush)
most common Salter-Harris fracture
type II
Which Salter-Harris fractures require surgery?
4 and 5
Shigella tx
azithromycin or cipro
Shigella complications
HUS, reactive arthritis, seizures, confusion, hallucinations
pediatric rectal prolapse
consider CF
infantile spasm
< 1y w/neurodevelopmental delay and clusters of spasms a few mins at a time
tx: ACTH, steroids, benzos, vigabatrin
Hirschsprung disease is associated with
trisomy 21, male sex
adenosine dosing
dose 1 = 0.1 mg/kg
dose 2: 0.2 mg/kg
newborn RR
50
1yo RR
30
Tetralogy of Fallot
P - pulmonic stenosis
R - RV hypertrophy
O - overriding aorta
V - VSD
breastfeeding jaundice
jaundice in the first week of life 2/2 poor intake or poor maternal production
SVT: adenosine and cardioversion dosing
- 1 mg/kg (max 6 mg) > 0.2 mg/kg (max 12 mg)
cardioversion: 1 J/kg > 2 J/kg
epi dosing
0.01 mg/kg
needle cricothyrotomy
14/16-gauge needle with angiocath > attach syringe with saline and aspirate (hopefully bubbles) > advance angiocath > attach 3.5mm ETT cap and BVM through it
