PEDIATRIC MOCK CODE

Red Flags in Pediatric Assessment

• Drug dosage

• Equipment size

• Broselow

• Handtevy

Handtevy

handtevy.com

The Three Way Stopcock…• Great for small doses

• 4.5kg

Medication Concentration Order/Desired Dose

Dose in MLs

EPI 1:10,000 1mg/10ml 0.01mg/kg 0.45ml = 0.045mg

Atropine 1mg/10ml 0.02mg/kg 0.9ml = 0.09mg

Fentanyl 250mcg/5ml 2mcg/kg 0.18ml = 9mcg

Versed 10mg/10ml 0.1mg/kg 0.45ml = 0.45mg

Fluids• 4-2-1 Rule for Fluid Maintenance

• 4ml/kg for first 10kg +

• 2ml/kg for 10-20kg +

• 1ml/kg for everything kg over 20kg

= ML/HR

8kg= 32 ml/hr (4ml x 8kg)

15kg= 50ml/hr (4ml x 10kg + 2ml x 5kg)

• Bolus

• 20ml/kg Pediatrics

• 10ml/kg for Neonates and cardiac kids

• What type of fluid??

Pour some sugar on me…• Hypoglycemia

• < 40 in Neonates• < 50 in Pediatrics

• D10; 2mL/kg Neonates5mL/kg Pediatrics

• D50

Respiratory Syncytial Virus (RSV)• Most common cause of Bronchiolitis

• #1 cause of infant hospitalization world wide

• Almost all children are infected by the age of two

• Infection of small airways • Inflammation

• Immune response

• Cellular sloughing

• Excessive mucus production

• Risk factors • Cardiac issues, prematurity, Down syndrome, underlying lung

disease, exposed to second hand smoke, under 12 weeks of age

RSV/Bronchiolitis Continued…• Clinical S/S

• Wheezing, tachypnea, increased respiratory effort, excessive mucus, poor feeding, fever, apnea

• Treatment• Supportive (O2, MIVF)

• SUCTION, SUCTION, SUCTION

• Antipyretics

• ABX?

• Steroids?

• Bronchodilators?

• CPAP/Intubation

Airway/VentilationRSI

• Meds, Apneic oxygenation• Correct size ETT• Cuff or no cuff? • Pediatric Airway anatomy• Ventilator settings

Pearls

• References• Pedi STAT

• Heartpedia

• Fast Facts Pediatrics

• Handtevy

• BluCard

Questions???

Thank You!

References• American Heart Association. (2011). Pediatric Advanced Life

Support. First American Heart Association Printing.

• American Heart Association. (2011). Neonatal Resuscitation (6th edition). First American Heart Association Printing.

• HANDTEVY Pediatric Emergency Standards. (2017). What is HANDTEVY? Retrieved from http://handtevy.com/index.php/about/what-is-handtevy

• DynaMed. (February 27, 2017). Bronchiolitis. Retrieved on April 25, 2017 from http://www.dynamed.com.frontier.idm.oclc.org/topics/dmp~AN~T115760/Bronchiolitis

• CDC. (March 7, 2017). Respiratory syncytial virus. Retrieved on April 27, 2017 from https://www.cdc.gov/rsv/clinical/index.html

Beginning of shift

At change of shift…

A little while later

Evaluation

• Text to this number: 39242

• Type this message: @BHDH

• You will receive a link to the survey