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

http://www.empeds.com/

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

SBP low range = 70 + age x 2

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"

• 1. Truncus Arteriosis 

  2. Transposition of Great Arteries

  3. Tricuspid Atresia

  4. Tetralogy of Fallot (Overriding Aorta, Pulmonary Stenosis, VSD, RVH)

  5. 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)