Review deck 2 Flashcards
Describe the maintenance fluid for a 35 kg child
4 mL for first 10
2 mL for second 10
1 mL/kg after
total 75 mL
Normal IV boluses for kids are
10-20 mL/kg
Describe how to estimate blood replacement
[(desired Hct-present Hct) x EBV]/Hct of PRBCs (~60%)
Cardiac arrest in the pediatric patient after receiving succinylcholine
treat for hyperkalemia
CPR should be started when HR is
60 bpm
Pierre Robin Sequence is made up of
hypoplastic mandible (micronathia) pseudo-macroglossia (posterior displacement of tongue) high arched cleft palate
Kids with CP may have
normal intelligence
Patients with CF will have
restrictive lung disease & high peak pressures
CHARGE association is associated with
a difficult intubation
MPS is associated with
a difficult airway
has valvular regurgitation/stenosis
atlantoaxial instability
For a child with down syndrome who experiences bradycardia on induction,
give atropine
Patients with Down syndrome may have
subglottic stenosis
atlantoaxial instability
hypothyroidism
more prone to bradycardia
Unique anatomical features of children include
prominent occiput
An ETT that is too big or overinflated will cause
subglottic edema
Patients undergoing cardiac arrest in the OR need to have
a definitive airway established
After 10 minutes of CPR or unable to obtain an airway,
the ECMO team should be activated
Calculating the 50th percentile weight is
(age x 2)+ 9
Neonates have a higher _________ which requires
ECF volume which requires larger doses of water-soluble drugs
Atropine dosage is
0.02 mg/kg
Adenosine dosage is
0.1 mg/kg
PO versed dosage is
0.5 mg/kg
The pediatric population goes to sleep faster with inhaled anesthetics because
increased RR
decreased FRC
_____ can be used for second gas effect
N2O
Calculate the dosage of adenosine for a 3 year old child.
age x 2 + 9= 15
15 x .1= 1.5 mg of adenosine
The use of these drugs in pediatric patients is associated with increased cardiac arrest
halothane
succinylcholine
Patients at increased risk for periop arrest include
ASA 4
<1 month old
premature
The agent of choice for inhalation inductions is
sevoflurane
The IV induction dose of propofol for peds is
1-3 mg/kg
Neonates have _____ sensitivity to NMBDS
increased; shorter onsets & may have prolonged duration of action
The intubating dose of rocuronium for pediatrics is
0.6 mg/kg
The dose of zofran for pediatrics is
0.1 mg/kg
the highest separation anxiety in children is seen in this age group
6 months-4 years
NPO guidelines for breast milk is
4 hours
Describe the calculation for determining tube size for kids
(age/4)+3.5
The code dose of epinephrine is
10 mcg/mL
T&A recommendations include
IV dexamethasone 0.5 mg/kg
no routine abx.
avoid ketorolac
manage pain
If a pediatric patient comes in with a fracture, this requires
an RSI
Describe what is used and the dosage for vfib/vtach
defibrillation
2-4 J/kg up to 10 J/kg
Cardioversion is used for
afib, aflutter, or SVT
synchronized with R wave
0.5-1 J/kg up to 2 J/kg
An IO should be placed in the
anterior tibia
Care after ROSC includes
pulse ox 94-99% assess for rebound of arrest inform family prevent hyperthermia hyperglycemia & seizures
What to do when caring for yourself after an adverse event?
don’t hide shit
When harvesting abdominal organs, avoid this vasopressor
phenylephrine
True or false: it is normal to see delayed urine output in living kidney donor transplant
false- should not be delayed
In order to determine brain death, the following must be ruled out
reversible cerebral dysfunction
Non-heart beating organ donors are brought down to the OR to
decrease warm ischemic time
The following cannot be part of the decision team or declare brain death
transplant team
recipient family
CRNA
Mannitol & steroids may be given to
scavenge free radicals
Organ preservation includes
cooling to decrease metabolism
maintain cellular integrity
prevent cellular swelling & toxic metabolite buildup
Organ preservation time of the heart & lungs
4-6 hours
Organ preservation time of the liver
8-12 hours
Organ preservation time of the pancreas
12-18 hours
Organ preservation time of the kidney is
24-36 hours
Brain death donors may have the following issues:
hypotension
diabetes insipidus
bradycardia
spinal-somatic reflexes
Preserving organ function includes
UO 0.5 to 3 mL/kg/hr
hgb >10
CVP 5-10
core temp >35
What medication should be given to brain dead patients with low HR & BP?
isoproterenol
Cardiac concerns for brain dead patient is
warm ischemic time
In pediatrics, the epiglottis is
angled over the cords
