Peds Fluids/Blood Flashcards
1
Q
MIVF calculation
A
- 1st 10 kg = 4 mL/kg/hr
- 2nd 10 kg = 2 mL/kg/hr
- kg over 20 = 1 mL/kg/hr
2
Q
NPO deficit
A
hourly maintenance x # hours NPO
50% in 1st hour
25% in 2nd hour
25% in 3rd hour
3
Q
type of fluids for peds
A
- balanced salt solution for deficits and evaporative loss
- at risk for hypoglycemia use D5 + 1/2 NS
- careful administration not to fluid overload
4
Q
max allowable blood loss
A
[EBV x (starting Hct - target Hct)]/starting Hct
5
Q
estimating blood replacement
A
[(desired Hct - present Hct) xEBV/Hct of PRBCs (~60%)
6
Q
EBV premie
A
100 mL/kg
7
Q
EBV term infant premie
A
90 mL/kg
8
Q
EBV 6 mos infant premie
A
80 mL/kg
9
Q
EBV children <1 year
A
75 mL/kg
10
Q
EBV children >1 year
A
70 mL/kg
11
Q
EBV adult
A
55-65 mL/kg
12
Q
FFP
A
- administered to replenish clotting factors lost during MTP
- observed coagulopathy
- prolongation of PT and PTT or ROTEM
- always use filter and warmer
13
Q
plts
A
- children whose plt count has fallen secondary to idiopathic thrombocytopenic purpura or chemo tolerate plt counts as low as 15,000 mm3
- children whose plt count is decreased d/t dilution generally require transfusion when count is < 50,000
- filter tubing, NO WARMING
14
Q
cell saver
A
- salvaging of RBCs from suctioned blood
- large volume of washed cells may lead to coagulopathy b/c of dilution of coagulation factors
15
Q
calcium supplementation
A
- rapid and multiple transfusions can lead to hypocalcemia
- severe ionized hypocalcemia leads to cardiac depression with hypotension
- FFP and PRBCs both have citrate (chelates calcium)
- neonates have decreased ability to mobilize calcium and to metabolize citrate
