Peds numbers and facts

Question 0

Peds doses for fluids, epi, naloxone, atropine, isoproterenol? Defibrillation, prbcs?

Answer 0

Epinephrine 10 mcg/kg
Narcan 10 mcg/kg
Fluid bolus 10 ml/kg
Atropine 20 mcg/kg
Isoproterenol 50 mcg/kg/min
Defib 2 joules/kg
PRBCs 10 ml/kg

Question 1

Peds cleft lip

“Rule of 10”

Answer 1

Hb 10 gm/dl
Weight 10 lbs
Age 10 weeks
WBC <10

Question 2

Approximate Peds weight by age, ie 7 yo

Answer 2

Weight in kg = 8 + 2*(age)

Ie 7yo = 22 kg

Question 3

Common Premie defects?

Answer 3

CBRAIN
Cardiopulm
Bronchopulmdysplasia - poor exchange
Retinopathy of prematurity secondary to hyperoxia - blindness - rop Hx keep spo2- 89-93
Apnea of prematurity. Lasts up to 55-60 weeks postconceptually. Tendency to become bradycardic. Admit under 60 weeks postconceptual
Ivh - bleeding in ventricle - scarring and clots in cerebral aqueduct - hydrocephalus
Nec - Mortality of 40% -

Question 4

Outpatient Peds surgery criteria?

Answer 4

In general >60 weeks post conceptual age ok for outpt without hospital admission most conservative guideline.
If born >37 weeks: 44 weeks pca
32-37 weeks: 52 weeks
<32 weeks: 60 weeks

Question 5

Normal urine specific gravity Peds and cut off for hypovolemia?

Answer 5

> = 1.009 hypovolemia

Adults frank dehydration sg 1.025

Question 6

How to calculate sodium deficit Peds?

Answer 6

140-current Na)(healthy body weight in kg)(0.4)

Multiply 0.2 instead of 0.4 in adults - extra cellular fluid as a percent of total body weight

Question 7

How many meq sodium in 1L NS?

Answer 7

154 meq

Question 8

Maintenence fluid retirements for npo dehydrated kids?

Answer 8

D5 1/4NS @ 4 ml/kg/hr

Question 9

Potassium replacement?

Answer 9

4 meq/kg/DAY
Withhold until adequate uop established
LR contains only 4 meq/L of K+

Question 10

Calcium repletetion neonates?

Answer 10

Calcium gluconate 100 mg/kg
Seizures, tetany, laryngospasm, hotn, cardiac failure if <4.5
Test dose 1ml to see if BP responds

Question 11

Difference between omphalocele and gastroischesis?

Answer 11

Omphalocele- has covering membrane sac

Gastroischesis does not have membrane. Hypovolemia secondary to large intestinal fluid loss generally more severe with gastroischesis than with omphalocele.

Concerns for both (“HAD”):
Hypovolemia
Acidosis
Dehydration, Depression of respirations and consciousness

Question 12

Bicarbonate dose when ph<7?

Answer 12

Dose hco3=wt kgdev HCO3 from 240.4 (infants)

Adults switch 0.2 with 0.4

Question 13

Epiglottitis vs croup
Age
Signs
Cause

Answer 13

Epiglottitis
Age 2-6y
Sitting up drooling mouth open leaning forward, thumb print X-ray
H. Influenza

Croup
3mo to 3 years
Subglottic steeple sign X-ray. Inspiratory stridor, barking cough, hoarseness
Viral