Special Forms/#s Flashcards
Estimating upper limit of RR:
= Age# - 40
Pedi Normal Urine output:
1-2ml/kg/Hr urine output
<1Yr pulse check @
Carotid
A surgical cricothyrotomy is contraindicated in patients less than
less than 8 years old
Adults vocal cords @
Pedi Vocal cords @
C4 - 5
C2 - 3
Age & French Suction Catheter Size) Up to 1 year:
1 to 6 years:
7 to 15 years:
16 years:
= 8
= 8-10
= 10-12
= 12
Child BVM bag vol/
Infant BVM bag vol/
= 800mL
= 300mL
Croup Med dosing:
RaceEpi) 2.25% 0.5mL + 4mLs of NS Nebulized
Epi 1:1) 1mL w/ 4mL NS Nebulized
Epi 1:10) 5-10mLs of Epi (no dilution) Nebulized
Croup vs Epiglottitis) Temp
Usually occurs @:
Common age:
=(C)Low fever101-2 (E)High fever 102-4
=(C)Before bed (E) in Morning/middle of night
=(C)6Mns - 4Yrs (E) 3Yrs - 7Yrs
Cuffed ET:
Indications:
Monometer cuff
Usually start at:
(Age /4) + 3.5
= Increased pulmonic P} Anaphylaxis, Burn, drown
= never over 30 mmHg
= 6.0 ~1st
Dextrose Pediatric Dosing
Conversion) D50 to D25:
D50 to D10:
- Neonate (<2 months): D10W, 5-10 mL/kg IV
- Infant (2Mn-2Yrs): D25W, 2-4 mL/kg IV
- Child (>2Yrs): D50W, 1-2 mL/kg IV
= Dilute by a factor of 2 (add equal Vol of fluid)
= Dilute by a factor of 5 (add 4x Vol of fluid)
Estimate pedi weight:
(age X 3) +7=Kg <New>
(age +4) x2=Kg <Old></Old></New>
Infant to 1 year)ETT Size:
Type:
Depth of ETT Insertion:
Laryngoscope Blade Size:
3.5–4.0
Uncuffed
9.5–11.0 cm
1 straight
ETT) Premature (1–2.5 kg; 2.2–5.5 lb*)
Neonate (2.5–4 kg; 5.5–8.8 lb)
6 Months (6–8 kg; 13.2–17.
1–4 Years (10–14 kg; 22–30.8 lb)
5 Years (16–18 kg; 35.2–39.6 lb)
5–10 Years (24–30 kg; 52.8–66 lb)
= 2.5–3.0 (uncuffed) formula
3.0–3.5 (uncuffed) formula
3.5–4.0 formula
4.0–4.5 formula
5.0–5.5 formula
5.5–6.5 formula
Laryngoscope blade) Premature
Neonate
6 Months
1–4 Years
5 Years
5–10 Years
0 (straight)
1 (straight)
1 (straight)
1–2 (straight)
2 (straight or curved)
2–3 (straight or curved)
French Suction/Stylet) Premature (1–2.5kg; 2.2–5.5 lb)
Neonate (2.5–4 kg; 5.5–8.8 lb)
6 Months (6–8 kg; 13.2–17.
1–4 Years (10–14 kg; 22–30.8 lb)
5 Years (16–18 kg; 35.2–39.6 lb)
5–10 Years (24–30 kg; 52.8–66 lb)
6–8/6
8/6
8–10/6
10/6
14/14
14/14
febrile seizures result from
Most commonly between ages of
= a sudden increase in body temperature.
= 6Mns & 6Yrs often, guardians report a recent onset of fever or cold symptoms.
fluid replacement after perfusion rule:
4 2 1rule/ formula :
= normovolemia Used for every hr after to maintain
4ml/kg 1st 10kg
2m/Kg 2nd 10kg
1ml/kG 3rd
Gestational Diabetes:
Rx:
= Diabetes from Carry w/ BGL < 70 mg/dL
= Administer 50-100 mL 50% dextrose
Pedi Uncuffed ETT form:
Pedi Cuffed ETT form:
= (Age in years ÷ 4) + 4.
= (Age in years ÷ 4) + 3.5
How to clamp & cut the umbilical cord after delivery:
What to do immediately after the baby is delivered:
= Delay clamping 30Secs after delivery, Clamp cord 4in. (10 cm) from navel; place 2nd clamp 2in (5 cm) from 1st &
Cut cord between clamps
= Dry baby; cover w/ warm, dry blankets or towels.
Position baby on side.
Record time of birth.
hypervent/ for Child w/ brainstem herniation
hypervent/ for Infant w/ brainstem herniation
ETCO2 target:
= 30 breathes a min (>1yr)
= 35 breathes a min (1mth - 1yr)
= ETCO2 target 35 mmHg
hypoglycemia for neonate:
= <45BGL neonate
hypoglycemia Rx for infant:
= <60BGL infant
hypoglycemic with PEDIs trick:
hypoglycemia Rx for neonate:
hypoglycemia Rx for infant:
= Lots of sick kids hypoglycemic so use bone marrow for BGL
= <45BGL neonate 2mns - 1yr
= <60BGL infant 1-3yrs
Pedi Defibrillation
Initial 2 J/kg, then 4 J/kg increasing to max 10J/Kg
Infant tachycardia
Children tachycardia
Note
> 220
180
get Hx, if sudden & random onset then SVT
Pedi Poisoning CCB/BB fluid form
= 5-10 mL/kg / 10-20Mins PRN
Pedi Fluid doses) Hypovolemia& Distributive:
Cardiogenic Shock:
Poisoning CCB/BB:
DKA with Compensated Shock:
= 20 mL/kg / 5-10Mins PRN
= 5-10 mL/kg / 10-20Mins PRN
= 5-10 mL/kg / 10-20Mins PRN
= 10-20 mL/kg / 60-120 Minutes
Pedi Hypovolemia& Distributive fluid Form:
= 20 mL/kg / 5-10Mins PRN
Pedi Cardiogenic Shock fluid form
= 5-10 mL/kg / 10-20Mins PRN
Pedi DKA Comp Shock fluid form
= 10-20 mL/kg / 60-120 Minutes
Neonatal Airway Management
Position airway, suction only if obstruction present, intubate if necessary
Neonatal CPR Indications
HR < 60 bpm despite ventilation & oxygenation
Neonatal CPR Reassessment Timing
Every 30 seconds, check HR, color, respiratory effort
Neonatal Fever Considerations
> 100.4°F (38.0°C) is concerning; workup for sepsis if present
Neonatal Heart Rate (HR) Ranges
At birth: 150-180 bpm, stabilizes to 130-140 bpm, HR <100 bpm = distress
Neonatal Hypoglycemia Treatment
Dextrose 10% (D10) at 5-10 mL/kg IV bolus
Neonatal Inverted Resuscitation Pyramid
Focuses on simple interventions first (warm, dry, position, stimulate), then escalate if needed
Neonatal Respiratory Rate (RR)
Normal 40-60 breaths/min, abnormal if <30 or >60
OG tube (French) Premature
Neonate
6 Months
1–4 Years
5 Years
5–10 Years
5
5–8
8
10
10–12
14–18
Premature infant) ETT Size:
Type:
Depth of ETT Insertion:
Laryngoscope Blade Size:
2.5–3.0
Uncuffed
8.0 cm
0 straight
Pedi HypoBP form/ & starts @
<70 + (Yrs x 2) Toddler: 1-3Yrs & up
Pedi Hypotension criteria cheat
Start @ 90 neonates w/ 60SBP w/ chidlren (1-10Yrs) for foumula
Pedi intubation indications
Bad physical signs NOT MONITORS
Pedi Polyuria
> 3ml/kg
Pedi PPV BVM rate:
1 every 2-3secs ~20-30breaths /min
Pedi Resp distress:
Pedi Resp failure:
= “Huffing & Puffing Enough” to sustain life
= “failure to respirate to sustain life” >60RR
Pedi Tension Pneumo decomp:
3rd rib 2nd ICS Chest wall thickness in anterior chest varies from 1.4 – 1.6 cm (0.55 - .63 inches)
1-3 years =
3-5 years =
6-12 years =
13-18 years =
Toddler:
Preschooler:
School-age:
Adolescent:
Pediatric Age Classifications
- Newborn: Birth to hours old
-Neonate: Hours to 1 month
-Infant: 1 month - 1 year
-Toddler: 1-3 years
-Preschooler: 3-5 years
-School-age: 6-12 years
-Adolescent: 13-18 years
Toddler:
Preschooler:
School-age:
Adolescent:
“Kid/Child”:
=1-3 years
= 3-5 years
= 6-12 years
= 13-18 years
= 8Yrs up, 45Kg up, before puberty
Pediatric Bradycardia Treatment
- If hypoxic → Oxygen & ventilation
- If unstable → Epinephrine 0.01 mg/kg IV/IO
- Atropine (0.02 mg/kg) if vagal cause suspected
Pediatric CPR Compression Depth & Rate
- Depth: 1/3 to 1/2 of chest AP diameter
- Rate: 100-120/min
- Ratios: 30:2 (1 rescuer), 15:2 (2 rescuers), 3:1 (newborns)
Pediatric GCS 2-5Yrs changes:
(E) Alert, shout, pain, none
(M) same but follows commands now spontaneous
(S) Coos, Consolable ,Crys, Crazy, none
Pediatric GCS (Glasgow Coma Scale):
= Modified to assess eye opening, verbal response, motor response
Pediatric GCS 0-24Mns changes:
(E) Alert, shout, pain, none
(M) same but follows commands now spontaneous
(S) Coos, Consolable ,Crys, Crazy, none
Pediatric GCS Differences
- Modified for age
- Verbal & motor responses changed for age
Ped Epi 1:10 dose:
Pedi Epi 1:1 dose
- Cardiac Arrest: 0.01 mg/kg IV/IO (1:10,000) - Anaphylaxis: 0.01 mg/kg IM (1:1,000)
Pediatric Synchronized Cardioversion Dosing
- SVT/VT w/ Pulse: Start @ 0.5-1 J/kg, increase to 2 J/kg if needed
Pediatric Vital Signs Considerations
- HR, RR higher than adults
- BP lower than adults
- Hypotension is a late shock sign
Pediatric Weight Estimation Formulas
- Old: (Age + 4) × 2 = kg
- New: (Age × 3) + 7 = kg
Suction form:
= 2 x ETT
How to estimate weight:
= (Age x 3) + 7 = Approximate weight in kg
Fetal Circulation) Foramen ovale:
Function:
Blood @ this time is De or oxygenated:
= hole between fetus’s atrias “fetal shunt”
= allows mixing of oxygenated blood in R-atrium, leaving the L-ventricle bound for the aorta. This serves to aid in blood flow bypassing the lungs.
= At this time, the blood is still oxygenated.
mLs range in uterus
= 50mLs-1.5Ls in uterus
Neonate age range
1st few hours of life to 1 month
newborn age range
Birth to the 1st couple Hrs of life
School-aged child age range
6Yrs - 12Yrs
Toddler age range
1 year & 3 years
Adolescent age range
13 years and 18 years
What are the definitions of Newborn, Neonate, and Infant?
Newborn: birth till a few hours old; Neonate: few hours till 1 month; Infant: 1 month till 1 year
Infant def
1 month till 1 year)
What are the steps in newborn resuscitation?
Dry, warm, position, stimulate; if HR < 100, positive pressure ventilation (PPV); if HR < 60, CPR (3:1 compressions-to-ventilation ratio)
What does the APGAR score assess?
Appearance (color), Pulse (HR), Grimace (reflex), Activity (muscle tone), Respiration (effort); scored at 1 & 5 minutes
What is hypoglycemia in newborns?
BG < 40 mg/dL, treated with D10 (5-10 mL/kg).
What is the appropriate depth for chest compressions in a child?
2 inches
What is the appropriate depth for chest compressions in an infant?
1 1/2 inches
What is the correct compression to ventilation ratio for CPR on an infant?
30:2
What is the correct tidal volume for a pediatric patient?
5-7 mL’s/kg
What is the CPR rate for a 6-month-old infant found unconscious?
At least 100/minute; ratio 15:2; depth 1/3 to 1/2 the depth of the chest
hypotension threshold for a 12-year-old pediatric patient?
Less than 90 mmHg systolic
hypotension threshold for a 19-month-old pediatric patient?
Less than 70 + (2 x age in years)
hypotension threshold for a 2-month-old infant?
Less than 70 mmHg systolic
hypotension threshold for a neonate?
Less than 60 mmHg systolic
hypotension threshold for an 11-month-old infant?
Less than 70 mmHg systolic
Neonatal CPR technique?
3:1 compression-ventilation ratio, 120 bpm rate, Two-thumb technique, Depth: 1/3 AP diameter.
fluid replacement for PEDI trauma PT form:
Best way to rapidly admin fluids:
= give 20 cc/kg NS/LR even if BP norm, repeat bolus if HR, LOC, CR & other signs of systemic perfusion fail to improve.
= 20mL/kG push pull push pull 3way stop cock
What is the pulmonary dead space volume for a pediatric patient?
3 mL/kg
What is the rescue breathing rate for a pediatric patient?
1 breath every 2-3 seconds
What pulse site should be used for an unconscious 5-month-old infant?
Brachial
Newborn’s heart rate normally be at birth?
150–180 at birth, slowing to 130–140 thereafter.
Newborn’s respiratory rate average?
40–60 breaths per minute.
- Dextrose Infant (2Mn-2Yrs):
D25W, 2-4 mL/kg IV
Dextrose Child (>2Yrs):
D50W, 1-2 mL/kg IV
What are the normal newborn vitals?
RR: 40-60 bpm,
HR birth: 150-180 bpm & after birth: 130-140 bpm
HR < 100 bpm = distress
Neonatal CPR Indications
HR < 60 bpm despite ventilation & oxygenation
Neonatal Hypovolemia Shock Signs
Pale, cool skin, poor capillary refill, weak pulses, lethargy
Neonatal Shock Treatment
Fluid resuscitation (10 mL/kg bolus NS or LR), treat underlying cause
Neonatal Respiratory Rate (RR)
Normal 40-60 breaths/min, abnormal if <30 or >60
Neonatal Heart Rate (HR) Ranges
At birth: 150-180 bpm, stabilizes to 130-140 bpm, HR <100 bpm = distress
Neonatal Inverted Resuscitation Pyramid
Focuses on simple interventions first (warm, dry, position, stimulate), then escalate if needed
Neonatal CPR Reassessment Timing
Every 30 seconds, check HR, color, respiratory effort
posterior fontanelle usually closes
anterior fontanelle closes
= in 2 or 3 months
= between 9 and 18 months
Key Steps in Pediatric Primary Assessment (ABCDE)
- Airway: Position in neutral sniffing, remove obstructions
- Breathing: Assess rate, effort, SpO₂
- Circulation: HR, pulses, perfusion
- Disability: AVPU/GCS, pupil response
- Exposure: Full assessment, prevent heat loss
hypervent/ for Child w/ brainstem herniation
hypervent/ for Infant w/ brainstem herniation
ETCO2 target:
= 30 breathes a min (>1yr)
= 35 breathes a min (1mth to 1yr)
= ETCO2 target should be 35 mmHg
Infants sings of comp/ shock & entering decomp/:
Hypoxica > Tachycardic > Bradycardic
Croup vs Epiglottitis) Virus type:
Onset:
Defining S/S:
= (C)Viral (E)Bacterial
=(C)Slow (E)Fast
=(C)Seal cough & Steeple (E)Drooling
Croup vs Epiglottitis) Temp
Usually occurs @:
Common age:
=(C)Low fever101-2 (E)High fever 102-4
=(C)Before bed (E) in Morning/middle of night
=(C)6Mns - 4Yrs (E) 3Yrs - 7Yrs
What is the GCS score for a 5-year-old with Eye Opening: To verbal, Motor Response: Localizes, Verbal: Inappropriate words?
12
When does the posterior fontanelle of a pediatric patient generally close?
3 months
When does the anterior fontanelle of a pediatric patient generally close?
9-18 months
What is the GCS score for a 2-year-old with Eye Opening: To pain, Motor Response: Withdrawal, Verbal: Cries and Screams?
9
What is the GCS score for a 7-year-old with Eye Opening: To pain, Motor Response: Extension, Verbal: Incomprehensible sounds?
6
Infant tachycardia
Children tachycardia
Note
> 220
180
get Hx, if sudden & random onset then SVT
Respiratory Distress:
Respiratory Failure:
= Open & Maintainable , Tachypnea , Good Air Movement, Tachycardia, Pallor (pink/white cheek), Anxiety, Agitation
= Not Maintainable, Bradypnea to Apnea, Poor/Absent Air Movement, Bradycardia, Cape Cyanosis, Lethargy/Unresponsive
Pedi Hypotension criteria cheat
Start @ 90 neonates w/ 60SBP w/ chidlren (1-10Yrs) for foumula
Cardiac arrest in infants & children usually from:
Respiratory failure or arrest
1 Killer 3rd trimester
Placenta Abruptio
Gestational Diabetes rx:
BGL < 70 mg/dL: Start IV NS & Admin/ 50-100 mL 50% dextrose intravenously
What 3 shunts are involved in the fetal circulation?
Ductus Venosus later lig terez
Foramen Ovale septum prinium
Ductus Arteriosus
When maternal blood volume increases, pregnant women will often receive supplemental iron to prevent anemia. This is because:
Although both red blood cells and plasma increase, there is slightly more plasma.
Jumpstart) Triaging
RPM Resp/ Pulse / Mental
Jumpstart) R of RPM
RR <15 or >45
Jumpstart) P of RPM
Radial pulse
Jumpstart) M or RPM
Mental status
