Pediatrics
Michele Lin's Tricks of the Trade: http://academiclifeinem.blogspot.com/2011/09/trick-of-trade-pediatric-ear-exam.html
http://www.pemdatabase.org/evidence_based_pem.html
Approximate weights:
Newborn: about 3 kg
12 month-old: about 10 kg
4 year-old: about 15-20 kg
9 year-old: about 30 kg
14 year-old: about 50 kg
BP: low range SBP = 70 + agex2
Contraindicated Medications
No cough or cold medicines under age 2
No phenergan under age 2
No ibuprofen under 2 months
No ketamine under 3 months
Drug Dosing
<27kg: bicillin 600,000 units IM
>27kg: bicillin 1.2 million units IM
<15kg 2mg Zofran
>15kg 4mg+ Zofran
Ceftriaxone: 50mg/kg IM/IV
Dexamethasone (croup): 0.6mg/kg max 10mg
Prednisone (asthma): 2mg/kg initial, 1mg/kg daily
Hypoglycemia empiric treatment
dextrose 0.5 - 1 g/kg =
D5 20 mL/kg
D10 10 mL/kg
D25 4 mL/kg
D50 2 mL/kg
Cyanotic Congenital Heart Disease = 5 "Terrible T's"
- Truncus Arteriosis
- Transposition of Great Arteries
- Tricuspid Atresia
- Tetralogy of Fallot (Overriding Aorta, Pulmonary Stenosis, VSD, RVH)
- Total Anomolous Pulmonary Venous Return
Pediatric Airway
12 minute lecture by Strayer: http://emupdates.com/2011/05/24/12-minute-screencast-pediatric-airway-for-emergency-physicians-who-are-not-also-pediatricians/
Uncuffed tube size = Age/4 + 4, cuffed tube size = -1
Depth = 3x ET tube size
Laryngoscope Blade = Central incisor to angle of mandible (Mellick, 2006)
Larynx at C1 in children, C6 in adults (straighter = Miller)