Description
WEIGHTAT BIRTH 3-12 MOS KILOGRAMS 3.25 ??? ??? + 9 2 Age (yrs) X 2 + 8 1-6 YRS POUNDS 7 Age (mos) + 11 Age ( yrs) X 5 + 17 Age ( yrs ) X 7 +5 7-12 YRS ??? ??? ? 7 − 5 2 HEIGHT AT BIRTH AT I YR 2 -12 YR centimeter 50 75 Age ( yr) X 6 +77 Inches 20 30 Age (yr) X 2.5 + 30 BODY SURFACE AREA : ?? ?? ??? (??) 3600 APGAR Sign Muscle tone (Acticity) Pulse Reflex irritability Grimace Color (Appearanc e) Respiration 2 active >100 Sneeze/cou gh All pink Crying, rhythmic effective 1 Some flex./ext <100 Some grimace or avoidance Body pink, ext. blue 0 limp No pulse No response blue/pale Slow/irregul ar, ineffective Compression depth Approximately 1/3 to ½ depth of chest Approximately 1/3 to ½ depth of chest Approximately 1/3 to ½ depth of chest Compression rate 100/min >100min 120 events/min ( 90 compressions /30 breaths) Compression ventilation ration 5:1 ( pause for ventilation until trachea is intubated) 5:1 ( pause for ventilation until trachea is intubated) 3 :1 PENICILLINS Amoxicillin (Amoxil, Himox, Jamox) 30-50 mg/kg/day q 8 po AmoxicillinClavulanic Acid or Coamoxiclav 30-50mg/kg/day q8 IV,PO Ampicillin (Ampedia, Ampicin) NB: 50-100 mkd q 6-8 IM/IV (up to 1 wk) 100-200mg/k/d q8 (1-4 wk) IN,CH: 100-200 mkd q 4-6 IM/IV Syrup: 125mg/5ml, 250mg/ml cap:250mg, 500mg vial: 100,125,500mg/vi al AmpicillinCloxacillin (pensyclox, Ampiclox,Cl oxamicin) Ampi 250mg + cloxa 250 mg Same as ampicillin 250 mg cap 250mg/5ml syrup 75, 250, 500 mg vial absent NEWBORN RESUSCITATION ( Outside Delivery Room) 1. Warm, Position, Suction, Dry, tactile stimulation 2. Oxygen (Blow by) 3. Bag-Valve Mask Ventilation ( If heart rate < 100 Bmp or gasping respiration 4. Chest compression ( if heart rate < 60-80 bpm after ventilation intiated) 5. Medication – Epinephrine (if heart rate continues to fall or remains < 80 bpm) Maneuver Airway Breathing Initial Subsequent FBAQ SUMMARY OF ABC MANEUVERS Child Infant 1 – 8 years <1 year old old Head tilt-chin Head tilt-chin lift lift ( if trauma is ( if trauma is present ,uses present ,uses jaw thrust ) jaw thrust ) 2 breath at 1 2 breath at 1 to to 1 ½ sec/ 1 ½ sec/ breath breath ≈20 ≈20 breath/min breath/min Heimlich Back blows maneuver and chest thrusts circulation Pulse check Carotic Compression landmarks Lower half of sternum Compression method Heel of 1 hand Newly Born Head tilt-chin lift ( if trauma is present ,uses jaw thrust ) 2 breath at approximately 1 sec/breath ≈20 breath/min Back blows and chest thrsut Brachial or femoral 1 finger width below intermammary line 1 finger width below intermammary line 2 thumbencircled hands ( for 2 providers) or 2 or 3 finger 2 thumbencircled hands ( for 2 providers) or 2 or 3 finger 250,500mg cap 100mg/ml drops 125, 250mg/5ml susp (Moxicillin, pediamox, sumoxil,wyamox) Syrup: TID 156mg/5ml (125mg amox) 312mg/5ml (250mg amox) Cap: 375mg/tab (250mg amox) 625mg/tab (500mg amox) Vail: 300mg/vial (250mg amox) 500mg/vial (500mg amox) 1.2g/vial (1g amox) Syrup BID 457 mg/5ml (4oo mg amox) 228.5 mg/5 ml ( 200 mg amox AmpicillinSulbactam (unasyn) Drops:A60mg + C 30mg q 6 Infant vials: A50mg + C25mg q8 NB: 100mg/k/d q 12 (up tp 1 wk) q8 (1-4 wks) 50-100mg/kg/day q6-8 IV,IM 30-50 mkday q8 (oral) BacAmpicillin (Bacacil, Penglobe) IN,CH: 25-50 mg/kg/day q 12 po A: 800-1600mg/k/d q 12h Umbilical 375 mg tab 375 mg vial (A250mg + S125mg) 750 mg vial (A500mg+ S250mg) 250 mg/5ml 200, 400, 800mg tab 200mg/5ml susp 000u/5ml) PO 500mg cap (Megapan.000-100.000 Skin infxn: 150. 1 g vial (Mefoxin) 1 g vial (Rocephin) IM: 250mg.CH: 100-200 mg/k/d q 4-6h IV Pen V 50.000 u/kg single dose IM 1.. 500mg. 125mg/ml susp 125mg.000-50.000-1.000-100. (800.000u/5ml) ethylhigh dose: 150. 500 mg pulvule 1g/vial (Keflin) (Stancef) 500mg & 1 g vials 250. 1g/vial Cloforan 250mg. 1.000 125mg/5ml (phenoxym U/kg/day q6 (200. 2g vials Drops:20mg/ml Susp:100mg/5ml Cap:100mg.000 u/kg q 4-6 IM/IV 25.000. 500mg cap 125mg/5ml susp 250mg/5 ml susp 250 and 500 mg vial 250mg vial 500 mg vial Oxacillin CEPHALOSPHORINS 1st GENERATION Cephalexin TD: 30-50 mg/k/d q6-8 monohydrate OM: 75-100 mg/k/d Cefalothin Na NB<1200g: 50 mkd q12 (0-4wks) >1200g: 50-75 mkd q 8-12 (up to 1 week) 100150mkd q6-8 (1-4wks) IM/IV over 15-30 min IN.vial 4 wks Crystalline (Rheumatic Fever 1M and 5M u vial prophylaxis) Procaine NB: 50.4 M u 600.5g q8 Cefuroxime 100-150 mg/kg/d q8 IM/IV 10-15 mkday q12 oral 250mg/kg/d q 6 IV (for bacterial meningitis) OM: 40mg/k/d q 12 >5 yrs: 30 mkd q 12 >5 yrs: 40 mkd q 12 A: 250mg q 12 Cefetamet CH<12 yrs: 10 mg/kg q 12 >12 yrs: 500 mg po q 12 Cefoperazone CH: 100-150mg/k/d q 6-8 IM/IV A: 2-12g/d IM/IV q 6-8 Cefotaxime IN. 1 g (inj. 200mg (Tergecin) 500mg 1 g vials 250mg.000u/k/d x 10 days 80-160 mg/k/d q 6h life threatening: up to 2g/k/d q4 Cefazolin NB: 40mg/k/d q 12 (1st wk) 40-60mg/k/d q8-12 (14 wks) IM/IV over 15-30 min IN. 500mg.000250. Ultraxime) Ceftizoxime (3rd gen) Cefotaxime Ceftazidime NB<2000g: 100mg/k/d q12 (up to 1 week) 150mg/k/d q8 (1-4 wk) CH: 100-150 mg/kg/day q 8 A: 1-6 g/d q8 IM/IV 3-8 mkday q 12 CH: 40-80 mg/k/d q 6-12 A: 500mg-2g/d q 6-12h IM/IV 100-200mg/kg/day q6-8 IV 90-150mg/kg/day q8 IV (keflex) 100mg/ml drops 125mg/5ml susp.000ukd. w/ lidocaine) IV: 250mg.000-100. 1g/vial Fortum .000 1.000 illin U/kg/day q6 IV PENICILLIN G (PENADUR) = Wt x 100 /600 Benzathine 50. 250mg sachet susp.000250mg/5ml penicillin) 200.000. 250mg.000-400.CH: 50-100 mg/kg/d q6-8 po A: 2-4g/d q 6 po 250.CH: 50-100mg/k/d q 12-16h A (gonorrhea): 500mg IM/IV SD Cefoxitin 80-160 mg/kg/day IM/IV q 4-8 3rd GENERATION Ceftriaxone 50-100mg/kg/day q12-24 (3rd gen) IV Typhoid:75-80mg/kg/day x A: 1-4 g/d Ceftazidime (3rd gen) Cefixime ( Tergecef Zefral.2 M & 2.5g vial. 500mg. 750mg.CH: 100.Aztreonam (Azactam) Cloxacillin (Orbenin.CH: 50-100mg/k/d q8 IM/IV 2nd GENERATION Cefaclor IN.CH: 100-200 mkd q 6 IM/IV (over 30 mins) 50-100mg/kg/day q6 IV A: 2-12 g/d q4-6 IM/IV (over 30mins) Nafcillin NB: 40mg/k/d q12 IV 250mg/5ml susp (Vigopen) (up to 1 wk) 250 mg cap 60-80mg/k/d q 6500 mg and 8h (1-4wks) 1 g vial IN. w/ 1% water) (Fortum) 250mg. 1 g vials (Claforan) 250mg. 1 g vial IN.000 U/kg/day q6 (400. 500 mg 1 g cap 250.2 M u IM q3. IM q 12-24 Meningitic: 200.Pantacillin. 500mg.CH: 90-120 mg/k/d q 6-8h Severe or life threatening infxn: 2 gms IV q 6-8 h 500 mg. 500 mg tab 250mg/5ml susp (cefobis) 500 mg. 500mg tab Zinnat: 125. 250mg/5ml susp 250.000 U/vial meningitic dose: Benzylpenic 200. medoxypen) Aqueous 50. 500mg coated tab (globocef) 250. 250mg.000 u) Sumapen. 125mg.000400. 500mg. 500 mg cap 125mg/5 ml susp 250mg/5 ml susp Zinacef: 250mg.000 u/kg q 6 IV/IM IN.500mg 1g.CH: 20-40mg/kg/day (ceclor) po q8 A: 750mg-1. Prostaphlin A) NB<2kg: 60mg/k/d q 12h IV/IM (1st week) 90mg/k/d q 18h IV/IM (1-4 weeks) NB>2kg: 90mg/k/d q 8h IV/IM (1st week) 120mg/k/d q 6h (1-4wk) IN. 1 g (inj.000 U/vial Pen G U/kg/day q6 5. Pn.CH>3mos: 15mg/k/d q6 A: 1-2 g IV infusion *Crea clearnce of 15ml/min should not receive unless hemodialysis is instituted within 48 hrs 5-8 mg/k/d q 12 (dalacin-C) 150mg. chlorambid) 125mg/5ml susp 250mg.5 or 2 ml vial) 10mg/ml 40mg/ml (2ml amp) 50mg/ml (trisovit) 100mg/m l(nicetas.Trisofort) 100.CH: 50-100 mkd q6 po IM/IV (pediachlor. (2ml) vial 50 mg/ml (2ml) vial 20mg/2ml amp 60mg/1.trisovit) 150mg tab (pyrina) 325mg. 200mg BID po x 7-14 UTI. Microbid) 40mg+200mg/5 ml Triglobe: 6-7. 600mg cap 600mg vial 250mg/5ml 500mg/tab 100mgtab (pyrifort.A: 15 mkd div q8 IM/IV (over 30-60 min) LD: 10 mg/k/dose Gentamicin NB: (Garamycin. 11pm) the day before sx Roxithromyci A: 1 tab BID po 15-30 n (Rulid.5mg/kg/day q8 IV.2-2kg: 15mg/k/d q8 >2g: 15mg/k/d q8 or 20mg/k/d q6 IN.2pm. days sinusitis.CH: 10-40 mg/k/d q6 IN.5 mkd q8-12 (1-4 wks) IM/IV (over 12h) IN. 500mg cap 200mg/5ml susp 400mg/5ml susp 500 mg vial 100.CH: 10-20 mkd.5mg/kg/dose q8 IV.CH. IV over 15-30 min (1st week) IN. po (not >1. wk) Pediakin) 15-22.MACROLIDES Azithromycin CH: 10mg/kg/day x 3 days or alternatively for 5 days w/ a single 10mg/kg dose on day 1 then 5 mg/kg on D2-5 Clarithromyci CH: 15mg/kg q12 po n A: 500-1000 mg q12 Severe infxn: 2 tab BID x 6-14 days Erythromycin IN.5g) Strept omyci n 25 CH: 20-40mg/kg/d qd IM x 2mos (max 1 g/d) A: 15-25 mg/kg/d or 1 g daily. IM 250mg/ml.IM (Netromycin) Inoflox. skin & soft tissue infxn 300-600mg as single Gonococcus dose Non100-200mg BID x 7-14 gonococcus days GI infection 200-300mg BID x 5-7 days 250mg cap 200mg/5ml powder for oral suspension (Klaricid) 250mg tab 125mg/5ml susp (Erycin. min before meals Macrol) QUINOLONES Ciprofloxacin A: 500mg-1. 300. 7. 250mg/5ml) 100mg/2. Qinolon Chloramphen icol ImipenemCilastatin 45mg+205mg/5 ml Bacidal 80mg+400mg/5 ml 160mg+800mg forte tab 80+400mg tab/cap 160mg+800mg tab (Tienam) 500 mg imipenem 500 mg cilastatin. 18 h (0-4 wks) Progara) <1200g: 5 mkd q 12 (1st wk). Chloramol. 450. OD 10-15 1-pre or 2 post meal A: 600mg/d single daily dose (max 600mg/d) PZA CH: 30-35 mkd (max 15-30 2g/d) qd po A: 20-35 mkd po before meals EMB 15mg INH +125mg 15-25 EMB/5ml A: 15-25 mg/kg/d qd. qd.300.5 mkd q 8 IM/IV (over ½-2h) Netilmycin 2. <1200g: 2. CH: 5-8 mkd q8 IM/IV (over 1-2 h) 5 mkd A: 3. pre-breakfast (pyridoxine: 10mg/100mg INH to prevent S/E) RIF IN. 400mg 125mg/5ml 500mg tab 1 g vial .5 mg/kg q 14Servigenta.5 ml amp 80mg/2ml amp 25mg/ml (2ml amp) 50mg/ml (2ml amp) 100mg/ml (1. chlormycetin. 100mg BID po x 2-7 UTI days Compl. (2ml) vial 125mg/ml.IM ANTI-TUBERCULOUS DRUGS INH IN.pyrifort) 150mg/5m l(Odinah) 200mg/5ml (comprilex. OM.5ml drops 250mg.CH: 10-20 mg/kg/d 5-10 (max: 300mg/d)qd A: 8-10 mg/kg/d (max 300mg/d). 500mg cap 1 g vial Clindamycin NB<1200g: 10mg/k/d q 6 (1st 4 wks) 1.400 mg tab 100 & 200mg/5ml 150.5 mkd q 8 (1-4 wk) IM/IV (over 1-2 h) IN.5 g po q12 (Ciprobay) 100-200 mg as IV infusion for 30 min q12 Norfolxacin UTI: 200-400 mg BID GI infxn: 400 mg BID Gonorrhea: 800mg SD Ofloxacin Uncom.CH: 30-50mg/kg/day q6 po 15-30mg/k/d q6 SIV infusion A: 1-2 g/k/d q6 po 1-4gkd q6 IV Int. 300mg cap 150mg/ml amp Cotrimoxazole (SMX-TMP) AMINOGLYCOSIDES Amikacin NB: 15 mkd q12 (1st (Amikin. 200mg tab Tobramycin ( Nebcin) NB<1200g: 25mkd q 24h (0-4 wks) >1200g: 25-50mkd q1224h. 1 amp (Bactrim. Macrodin. Septrin. Ilosone 125mg/5ml. antisepsis: 1 g/dose x 3 doses (1pm. 5-10 ml TID 8-12 yr: 10-15 ml TID A: 1 capsule or 30 mll TID Solmux: 1-3 yrs: 2. Decolsin. A: 2-10gtts (0.01 ml/kg (max of 1 ml in 3 ml NSS or 5-10 gtt in 2 ml NSS) q 6 Naloxone Dose: 0.5 neb 200ug rotacap 0. 250 mg tab (nuelin.1-0.4 kg x 200 mg/ml = 290 mg/ml x 100mg /ml = 2.18-5 mkd po q 8 or 0.5 ml tsp q 6-8 ( 6 mos-3 y/o) or 5 ml q 68 hrs recommended dose: 0.01 ml/kg (max 1 ml) in 3ml NSS or 5-10gtt in 2ml NSS q6 Nifuroxazide (ercefuryl) < 6 monts 1 tsp BID > 6 months 1 tsp TID Terbutaline Calcium Gluconate Dose: 200-300 Ex.5ml neb or 5mg/2. 7mos-2 yrs: 1 cc Per infant drop phenylpropanolamine 3-12 yrs: 1 tsp TID BRONCHODILATORS Aminophylline 3-5 mg/kg/dose or 0.25 cc Dimetapp maleate. tynostan) 250.Venteze 1. CH: 1. 50 mg tab 100 mg tab (SR) 25mg/ml (3ml) amp 50 mg/5ml susp (ponstan. Zadilen) 1mg cap 1mg/5ml syr spiropent COUGH PREPARATIONS MUCOKINETICS Ambroxol HCl <1 yr: 12 mg/day (bronchopront.1mg/inhalation (Asmalin) 5mg/ml resp soln 0.25 ml QID 2-6 mos: 0.5mg/ml (2ml)amp 0. 0.5 mg/kg/dose q 6 h Paracetamol 10-15 mg/kg/dose q 4-6 h Ketotifen Clenbuterol PREPARATION 80 mg.5mg/5ml syr (betalin. 100 d (zaldec.9 mg/k/hr LD: 5-7 mg/k/dose MD: 3-5 mg/k/dose q 6 hr + 2 or 3 cc IVF to run for 20-30 min Ipratropium + Fenoterol (Berodual) 7 yrs.15 mkd po q 6-8 or 2.5 ml 15. WT x dose x prep 1.5 ml QID 7-12 mos: 1 ml QID 1-3 yrs: 5-7.25 mg/ml 2-6 yr: ½ tsp q 8 drops 7-12 yr: 1 tsp q 8 Combined Prep: Rondec.075 mg/k dose q 6 hr. Flemex.6-0. A: 1 tab TID or 1 tsp TID Bromhexine <2 yrs: ¼ tsp TID-QID HCl 2-5 yrs: ½ tsp TID-QID 5-10 yrs: 1 tsp TID-QID CH> 10 yr. 8 mg tab 100. 0.1 mg/kg/dose IV/IM/SC Theophylline prep: 80 mg/ml 26. mucuspel 4mg/5ml syr.5mg/ml (1ml) amp 1.5mg/ml (2ml) neb 0. 2 mg/ml soln. 500 mg tab/cap 150mg/ml (2ml amp) 125. or 1 mcg SC to rpt prn after 20 min once daily 6mos-3 yrs: 1 drop BID or 0. 250/5ml syrup 60mg/0. Triaminic.2-1.10. Dimetapp.5mg/d turbohaler. librentin.1-0.5 mg tab 5 mg tab (ER) 2.5 ml TID 4-7 yr: 7. 250 mg susp 325. 4 mg amp Bitussin. 4-6 mos: 0.5 ml 4-6 yrs: 10 ml 6-12 yrs: 15 ml 25mg/ml (10ml) amp 80mg/15ml syr (nuelin) 125.Kra movon.3 mg/k/d Immuzinc dose: 1-2 mg/kg/day prep: 20 mg /5 ml syrup 10 mg/ml drops Nebulizer 0. Drixine.5ml BID (<6 mos) Mucosolvan.7 mg/ml dose: 2. A: 2 tsp TIDQID Carbocisteine (Aflema. phenedrine) 120mg tab (tedral) MDI: 20mcg I + 50 mcg F/10ml 250mcg I + 500 mcg F/ 20ml inhalant 2mg/5ml syrup (activent. ventolin) 1mg/5ml expector 2mg tab 2.25mg BID Therasolvan.5mg/2.5mg/5ml 7-12 mos: ¾ ml q 8 syr 1-2 yr: 1 ml q 8 6. Simbron. Ameuslyn. mucolyptus. Laxobron.5 mg/kg/dose q12 ANALGESICS Aspirin Thrombolytic RHD activity Kawasaki Diclofenac DOSE 65-130 mg/kg/d q 4-6 h 3-5 mg/k/day 75-100mg/k/day 80-100 mkd q 6h x 2wks then 3-5 mg/kg x 6-8 wks CH: 50 mg tab BID during or after meals A: 75-100 mg daily Mefenamic Acid 6.5 ml) 3-6x daily ( min interval: 2 hours) Iron Supplement Dose: 3-5 mg/kg/day (maintenance) 6 mg/kg/day ( therapeutic dose) preparation: drops 15 mg/ml syrup 30 mg/5 ml Salbutamol 0.25 ml syr BID >3 yrs: 5 ml syrup BID <6 mos: 1 ml drops 6-24 mos: 2 ml drops 1-2 yrs: 5 ml syr 2-4 yrs: 7. 325 mg tab 25.1-0. pulmoxel. 1-2 yr: 15mg/day or Muxal.9 ml Nebulizer 0. <2 mos: 0. terbulin) 2. 500 mg tab 120.COLDS PREPARATION: Phenylpropanolamine (decongestant) 1-3mos: ¼ ml q 8 Disudrin 4-6mos: ½ ml q 8 12.8 mg/ml elixir.6 ml drops 0. Tridecon Brompheneramine 1-3 mos: 0.Bro nchotus.30mg/5ml syr 6mg/ml drops 15mg/2ml inhl’n soln 15 mg/2ml amp Bisolvon 8mg tab. 250 mg/5ml susp 50mg/ml drops 500 mg cap 40 mg/ml drop . bricanyl.5 cc Per 5 ml syrup phenylephrine. Sudafed. 1ml BID (7-12 mos) Mucovent. Bronkose.6 mg/kg/d Zobrixol) 5-10 y/o: ½ tsp BID-TID CH>10 yrs. 3 ml TID 50 mg/ml drop 3-6 mos: 0.5 . bisolvon (bromhexine HCl).6 ml TID 100mg/5ml.5-5ml BID 6-12 yrs: 5-10 ml BID >12 yrs: 7. 50mg cap 12.5 ml Solmux: 250mg/5 ml 500 mg/5ml suspension ANTI-CONVULSANTS Carbamazepine LD: 10-20 mg/kg MD: 5 mg/kg/day Clonazepam S-CARBOXYMETHYLCISTEINE (LOVISCOL. 7-12 mos: 0.5mg.5mg/5ml syr 50 mg tab Emes: 50 mg tab Vomex: 50 mg supp Serc.3 mkd A: 2-4mg/k/d mg-0. 2ml vial 125mg/ml.5mg tablets Na luminal: 130mg/ml amp 15. mucolex.33 mkd po 0. Robitussin AC (Guaifenessin+ codeine phosphate + pheniramine maleate). mension 6mg tab (mesylate) 8.65mg 97. 30mg/5ml susp 30.5 mg TID Plasil 5 mg/5ml syrup 10 mg tab 10 mg/2ml amp .03 mg/kg/d >10 yrs: 1.023-0.5 ml daily 2-6 yrs: 3 ml or 1-2 tabs daily Dramamine 12.100 mg tab 20 mg/ml syr 15 mg/kg/d div q 8-12 by 5-10 mg/kg/day weekly (max: 30 mg/kg/d q 8) gr ¼ = 15 mg gr ½ = 30 mg gr 1 = 60 mg Depakene 250mg/5ml susp 250mg tab Phenobarbital Valproic acid ANTI-EMETIC Dimenhydrinate LD: 10-15 mg/kg/dose MD: 4-8 mg/k/d q 8h *push DW before and after LD: 10-20 mg/k/d MD: 5-10 mkd 5mg/k/d QID 2-6 yrs: 2.5 mg/k/day <1yr: 1 mg BID 1-3 yrs: 1 mg BID-TID 3-5 yrs: 2 mg BID-TID 5-14 yrs: 2.5-50 mg/k/day TID/BID <6 mos: 0. 25 mg tabs 5 mg tab 2.9 ml TID 250mg/5ml 13-24mos: 1.010.5 ml BIDTID 6-8 yrs: 5-10 ml BIDTID 8-12 yrs: 10-20 ml BID-TID Infant: ¼ supp 1-6 yrs: ½ supp 6-12 yrs: 1 supp BID/TID ANTI-VERTIGO Betahistine A: 1-2 tab TID po with meals Meclezine HCl 12. Tuscalman Berna Dextromethorphan 1-2 tbsp 3-4 hrly or 5mg/5ml syr HBr 1-2 tabs q 4 hr 10 mg tab (max: 12 tabs/day) Expectorant + antitussive: mucolexin (Dextromethorphan + guiafenesin + Na citrate).C <10 yrs: 0.2-0.5mg/ml syr 1mg tab 2mg/2ml amp 25mg.Solmux) TID 4-7 yrs: 5 ml TID 8-12 yrs: 7.5 ml BID or ½ tab to 1 tab BID po or 0.05 -0.2 tabs/day accdg to age 15-30 mg BID 200mcg/dose misthaler 200mcg turbohaler 250mcg/ml respul 0.5-1 mkd (max 16mg/d) in 4 div doses.025 mg/k IM 3-5 mg/kg/day q 6 po. Protussa.5mg/5ml syr 30mg/5ml syr 60mg tab Diazepam (anxionil. 16 mg tab (dihydrochloride) Bonamine 25 mg tab Bonadoxine 8 mg/ml drops PROKINETIC (GASTRO-KINETIC DRUG) Metoclopramide 0. valium) Diphenylhydantaoin Tegretol 100mg/5ml syr 200mg tab Rivotril 2mg tab IN. 100 mg cap 100g/2ml amp 16. 4mg tab 5mg/ml amp(1ml) 4mg/ml vial(2ml) 50mg/ml. trazepam.3mg/k/dose 0. IV 10 mg OD or 1 mg/k/day BID ½.2 mg/k/d MD: <10 y: 0.2 mg/kg/dose 2-6 yrs: 2.60. 2ml vial 5 mg tab 8 mg cap semprex 4 mg tab 10 mg/ml (1 ml) amp 0.1 mkd 10-16y: 1. Bronchicum.2 mg/syrup 10. Cheryl IP (Guaifensin + Ipecac) Antitussive: Bractus.35 mg/kg/day or 0.4 mg/kg/dose 10mg/2ml amp 2mg. mucobran (Guiafenesin + Na citrate) STEROIDS Budesonide (budecort) Dexamethasone Hydrocortiso ne Status Asthmaticus Shock Prednisone C: 200-400 mcg BID initial MD: 100-200 mcg BID (max: 800 mcg daily) A: 400-800 mcg BID MD: 200-400 mcg BID 0.5 mg.2 ml susp TID 1-3 yrs: 1-1 ½ tsp TID 4-7 yrs: 1 ½ tsp TID 8-12 yrs: 2-3 tsp TID Mucolytic + expectorant: bromulex. Pertix.25mg 32.5 mkd q 12 to 4-6 mkd q 12 or as single daily dose HS Dilantin 125. Sinecod (Butamine citrate).MUKINYL. IM.30.5mg/5ml syr 50mg/ml (1ml) amp 0. 5 mg tab Sedation/sleep: 2-3 mkd q 8-12 Long term anticonvulsant start at 1. IV (for ICP) LD: 10mg/k/dose MD: 4-8mg/k/dose 10-20 mkd q 6 then 4 mkd q 4 until (+) response 50 mg/kg initial then 5075 mkd q 6 CH: 1-2 mg/k/d q 6 P: 40-60 mkd po ( for neoplasm) ANTI-HISTAMINES Acrivastin 1 tab TID po Chlorphenira mine (Antamine) Clemastine (Tavergyl) Diphenhydra mine (Benadryl) Hydroxyzine HCl (Iterax) Mequitazine (primalan) Terfenadine (Teldane) 0.VISCODEC) Loviscol <3 mos: 0. Simethicon Hyoscine-Nbutyl bromide (buscopan) IN: 0.5g/d) q day x 2 days (for ascariasis only) Pyrantel Pamoate 11 mg/kg/day (max 1 g) x 3 days ANTI-DIARRHEALS Nifuroxazide <6 mos: 2 tsp daily ( Ercefuryl) >6 mos: 3 tsp daily A: 1 cap QID Paromomycin + kaolin + pectin Bacterial <3 yrs: 1 tsp q 4 h diarrhea 4-14 yrs: 1 tbsp q 4h 25mg/kg q 6-8 hr x 5 Ameobiasis days Dysentery 35-60 mg/kg x > 6 doses Pre-op 35 mg/kg x 4 consec Hepatic coma days Taeniasis 75mg/kg Giardiasis 20-50 mg/kg/day x 5 days 20-30 mg/kg/day x 5-8 days OPTICAL ANTI-INFECTIVES: Zentel 200 mg/5ml syr 400 mg tab 100. A: 1-2 tabs 3-5 x daily ANTI-FLATULENT DimethylA: 1-2 tab TID po polysiloxane Chewable tabs 250 and 500 ml susp 200. 15ml drops (0.800 mg tab 100mg/ml (2ml) amp 100mg/5ml syrup 75.5 mg/5 ml syr Combantrin 250.5 g tube 0.5g tube 20mg/k/day po TID x 10 days 125mg/5ml CH: 15-20ml/kg/day or 2 tsp TID x 3 days A: 5 tabs BID x 3 days or 1 forte tab BID 100mg/5ml susp 200mg tab 500 mg forte EAR PREPARATIONS: 1. Gascon ANTI-HELMINTICS Albendazole Nematode 400 mg po Capillariasis 200 mg BID x 10days 400 mg q day x 3 Strongyloidiasis days Mebendazole 200 mg po BID x 3 (Antiox) days or 500 mg po one dose Piperazine (Expelin.0.5ml drops 2-3 gtts bidqid 3-4 gtts tid (5%) 5ml 10ml drops 10ml drops Polymycin B + glacialAerosporin acetic acid Polymycin B + Lignosporin 3-4 gtts tid lidocaine 3.5% 2.5-5ml TID/QID 6-12 yrs: 5 ml IN: ¼ amp TID IM.400. IV ANTI-SPASMODIC Bentyl 2.25%. 250 mg/5ml Quatrel: 100 mg/5 ml 100 mg tab 200 mg cap 220mg/5ml syr Humagel 150 mg cap 50mg/5ml susp Chloramphenicol solution ointment 1 gtt 2-4x/day (1 gtt/hr for acute cases) Apply inside surface of lower lid Framycetin solution ointment 1-2 gtts q 1-2h or 1-2 gtts 3-4x/day (acute) 2-3 application daily or at bedtime 1-2gtts into lower conjunctival sac 2-3h 1-2 gtts q4 ½ in ribbon into conjunctival sac 2-3x/day Sulfacetamide Tobramycin Solution ointment AMEOBICIDES Diloxanide furoate (furamide. Miscellaneous Antipyrine + Auralgan Moisten cotton Benzocaine + plug with solution glycerine then insert into dehydrated meatus tid-qid Dousate otosol Fill ear canal wit sodium soln & stay in position for 4-5 min then insert a cotton wool plug x 2 consecutive nights 10ml. 500 mg tab 100 mg/5 ml susp 1.5ml drops. elizol) Etofamide (kitnos) 0.5 g tube 10% 15% 5ml drops 3mg/ml (0.3%).5%.5-10 ml TID Dicycloverine HCl.5ml 3mg/g (0. Antiseptics with corticosteroids Polymyxin Cortisporin B+Neomycin+HAA Fluocinolone Aplosyn.25 mg/5 ml syr 62. 300 mg tabs 150mg/5ml syrup 50mg/2ml amp 10 mg tab 10mg/5ml syrup Relestal: 5 mg/ml drops 10mg/5ml syrup 10 mg tab 5 mg/5 ml syrup 20 mg/ml amp 40 mg tab Disflatyl. SC or slow IV CH.5-1 ml gtt or ½ tsp syr QID/TID 1-5 yrs: 2.5%) 10 ml drops . 1% 5 ml drops 0. 0. Aloxin) 75 mg/kg (max: 3. Anti-Infectives and Antiseptics Chloramphenicol Chloromycetin 3-4 gtts tidqid 3-4 gtts tidqid 5ml drops 5 ml drops 2-3 gtts tidqid 7.150. acetonide + Synalar polymyxin B + neomycin Triamcinolone kenacomb acetonide + neomycin + gramicidine + nystatin 2. 0.5% 2.5% 3.1%.3%) 3. 500 mg tab 125.ANTI-ULCER Antacid Cimetidine ( tagamet) Ranitidine (Zantac) 2-4 tabs chewtab QID 1 hr after meals or 2-4 tsp QID susp 5-7.5mg/kg/dose q 6 po/IV or 10-20 mg/kg QID 2-4 mg/k/dose BID po or 1 mg/k/dose TID. 1250.g.ANTI-FUNGAL Amphotericin B Candida Fluconazole(difl ucan) Griseofulvin Ketoconazole Nystatin (Mycostatin) NB: 100ug-1mg/kg/d over 6 hrs during 1st 4 wks of age IN.000 u/d q 4-6h AMEOBICIDES Furazolidone (furoxone) Intestinal Antisepsis 250mg.000-2.000 u/d q 4-6h.50. holds head responds to up steadily visual threat 4 Rolls over. off table follows object past midline 3 Supports Holds hands mo on open at rest. 16. po Metronidazole Ameobiasis Trichomoniasis 50.25mg/kg). and unison. clenches lifts chest fists tightly. po ANTI-VIRAL Acyclovir Premature Term VaricellaZoster Encephalitis Amantadine HCl Inosiplex Methixoprinol Linosine Ribavirin (virazole) 10mg/kg as 1hr IV infusion of 12hrs x 10-21 days 200 and 400 mg tab 250mg/ml (5ml) inj 10mg/kg as 1hr IV infusion of 8 x 10-21 days 2-12 yr: 20mg/kg (max:800) qid x 5 days >12 yrs: 800mg po 5x/day x 7 days 10mg/kg as 1 hr IV infusion of 8hrs x 4-21 days CH: 5-8 mkd po (max150mg) bid or tid A: 200mg OD ir BID <6mos: 1 ml q 3-4hrs 6-12mos: 1. Reaches mo supports on with arms in wrists. fashion. razz.000-400. follows to midline 2 Holds head No longer mo in midline. orients to voice Enjoys looking around Babbles.000 u tab 100.2kg: 20mkd q12 (1st wk) 30mkd q8 (14wks) IN. waves byebye. shifts brings hands weight to midline 6 Sits Unilateral mo unsupporte reach. 500mg cap 500mg/vial A: 800. anticipates feeding Laughs. crawls well.000 u vaginal tab A: 750mg x 3 doses 1 day before sx 25-50 mg/kg/day div q6 po NB<1. forearms in follows in prone circular position. holds bottle. puts feet raking grasp.CH: 35-50 mkd q8 x10 days A: 750mg TID po x 5-10 days Giardiasis C: 5 mkd q8 x 7 days A: 250mg TID x 5 days Anaerobic Infxn: C: 15 mkd q8 x 5 days A: 250 mg TID x 5 days Dose: 0.po A: 0.25 mg/kg/d OD. ahgoo. po CH: 5-10 mkd q12-24.2kg: 15mg/k/d OD >1. uses d. pincer grasp.000.25mg/k (increment of 0. 500mg tab 125mg/5ml susp 5mg/ml(100 ml)vial 1g suppository NB: 15mkd (initial) then 7. dada‖ indiscriminatel y.7mg/k/day TD: 20-30 mg/k/day LD: 6mg/k OD MD: 3 mg/k OD CH: 7. to 1 mg/k/d as single infusion over 6-8h 5mg/ml(10ml )vial 50mg reconstituted with 10cc sterile water to make 5mg/ml IN. stand. 200mg/cap 2mg/mlvial 330 mg tab 5-8mg/k/day QID NOT FOR G6PD 50mg/15ml. in mouth in transfers supine objects position 9 Pivots Uses mo when immature sitting. understands ―no‖ Uses two Starts exploring environment. probes with pulls to forefinger.000-800.1mg/kg for 2hrs (test dose) 2nd day: 0. po NB: <2kg: 200.5ml q3-4 1-2yrs: 2ml 2-6yrs: 3ml 6-12yrs: 5ml A: 1 tab LD: 100mg/kg/day MD: 50mg/kg/day CH: 15mg/kg/d in 3 or 4 div doses A: 800mg/day (1st day LD of 1600mg) q6 100mg tab 50mg/ml (Immunosine) 500mg tab 250mg/5ml (Isoprinosine) 500mg tab 250mg/5ml syr 200mg cap 20mg/ml syr 100mg/ml amp 6g/vial aero DEVELOPMENTAL MILESTONES Age Gross VisualMotor Motor/Proble m Solving 1 Raises Birth: mo head from Visually fixes prone position 1 mo: Has tight grasp.33-). gestures.. cruises throws objects 12 Walks Uses mature Language Social/Adapti ve Alerts to sound Regards face Smiles socially (after being stroked or talked to) Recognizes parent Coos (produces long vowel sounds in musical fashion) Reaches for familiar people or objects.000-800.6mg/5ml 100mg tab Flagyl IN.CH: 400. lateral orientation to bell Recognizes that someone is a stranger Says ―mama. po A: 200-400 mg OD.5 mkd q12 IV CH: 30 mkd (max 4g/d) q6 po/IV A: 500mg q6 po/IV or 300mkd (max 4g/d) q6 po/IV 200mg tab 100.CH: 1st day: 0. plays gesture games (e.CH: 40mg/k/d q6-12h A: 2mg/d IV q6-12h 250.66g/d OD. pat-a-cake) Imitates .000 u/d q 4-6 h.000 u/d q 4-6h po >2kg: 400.000 units/ml susp Tetracycline Vancomycin 500. 150. plays in company of other children Parallel play Normal respiratory rate <60 <50 <40 <30 Age <2 mo 2-12mo 1-5yo 6-8y/o -. one-step command with gesture Uses 4–6 words. unbuttons Hops.NORMAL RESPIRATORY RATES IN CHILDREN Age Respiratory Rate (breaths/min) (yr) 0–1* 24–38 1–3 22–30 4–6 20–24 7–9 18–24 10–14 16–22 14–18 14–20 Age NB 2y/o 4y/o >6y/o Normal heart rate 110-150 85-120 75-115 60-110 Weight IBW preterm term At birth 3-12 mo kg (# of days -14) x 15 + BW 9gms (# of days -10 x 20 + BW 9 grms 3. pants. likes to help in household tasks Holiday Segar BW (kg) 1-10 y/o 11-20 >20 50 cm (20 in) 75 cm 3 ft. uses two-word sentences Uses minimum of 250 words. releases voluntarily Creeps up stairs. follows one-step command without gesture Mature jargoning (includes intelligible words). BL x 2 (age in yrs x 5) + 80 Fluid volume 100 ml/kg 1000 ml+ 50 ml/kg for each kg > 10kg 1500+ 20 ml/kg for each kg > 20 kg Ludans method <15 kg <2 y/o mild moderate 50 100 >15 kg >2 kg 30 60 ¼ PLR ¾ D50. asks what a word means Cal per kg 115 110 110 90-100 80-90 70-80 55-65 45-50 Prot g/kg 3. catches ball Copies triangle. gender Tells ―tall tales.25 Age in months + 9 2 (age in yrs x 2) + 8 (age in yrs x 7) – 5 2 1-6y/o 7-12 y/o Length Ave BL 1 y/o 3y/o 4y/o >2y/o Group play. dries hands if reminded. me) inappropriately .‖ plays cooperatively with a group of children Plays competitive games. knows 5 body parts Uses pronouns (I. removes shoes.5 3. dresses partially. turns 2–3 pages at a time Can alternate feet when going up steps. ties shoes. buttons clothing. builds tower of 3 blocks.2 actions. you.3 or 0. alternates feet going down steps Copies a square.mo 15 mo 18 mo 24 mo 3 yr 4 yr 5 yr alone pincer grasp.9 NaCl 154 D5 mannitol 49 25 D5 NR 140 5 D5 NM 40 13 D5 IMB 25 20 NP 30 20 D5NSS 150 D5W - Cl 109 51 75 154 19 98 40 22 25 150 - base 28 20 50 16 23 23 - Mg - .0 2.9 6-7hrs For every degree rise in temperature add 12% Of maintenance IVF components (meq/L) Na K D5LRS 130 4 D5 0. asks questions Prints first name. follows twostep commands. abides by rules. repeats two digits Knows colors.5 1.0 1. uses plurals. spreads with knife Skips alternating feet. skips. 7–10 word vocabulary. jargoning (runs several unintelligible words together with tone or inflection). knows all pronouns. plays well with others.9 6-7 hrs severe 150 90 1/3 PLR x 1 hr 2/3 D5 0. walks backwards independen tly Runs. dresses self completely. jumps over low obstacles Age 0. knows full name. etc. dusting). age. comes when called. undresses completely. throws objects from standing without falling Scribbles in imitation. Scribbles spontaneous ly. cooperates with dressing 15–18 mo: Uses spoon and cup Copies parent in tasks (sweeping. pedals tricycle Copies a circle. has a 50– word vocabulary. 3– word sentences. builds tower of two blocks in imitation Walks up and down steps without help Imitates stroke with pencil.3 Nacl 51 D5 0.5 mos 6-11 mos 1-2 yrs 3-6 yrs 7-9 yrs 10-12 yrs 13-15 yrs 16-19 yrs words other than mama/dada or proper nouns.5 1. builds tower of 7 blocks. says song or poem from memory.45 Nacl 75 D5 0. shares toys. turns pages one at a time. can make a crayon mark.5 1. takes turns.5 2. 5 – 1 g/kg + insulin 0. 4x 10 kg = 40 meq C.2 units/ kg over 30 minutes Bicarbonate Correction Total Bicarbonate correction = Wt.02 x 60 = 15 ml to run for 60 min ECG : tall/peaked T waves .5 meg/l Mgt: glucose 0. 12 kg B. Maintenance Wt x 4 meq # of vials needed = 12 kg x 2g/kg 2. prolonged PR interval.O in 24 hours Albumin Transfusion Sodium (Na) Normal value: 135-145 meq/L A. Via infusion pump if no adverse reactions noted.2 ml div into doses X ml 10 ml (500mg/vial) 20 ml (1000 mg/vial) 50 ml (2500 mg/vial) 100 ml (5000 mg/vial) 200 ml ( 10000 mg/vial) .5-4.O in 24 hours(if with diuretics ) If w/o diuretic use BSA x IWL + U. x Dose (2g/kg) preparation(g/ml) Ex. Running rate : 0.5 meq/l/hr (increased running rate can lead to osmotic demyelination) Na correction: ½ by 1st day the rest over 24-48 hours Dose: 0. hjeadache etc.5 meq/m2/hr IVF correction should not exceed 40 meq/L 2.9 8-10. To compute for deficit (Desired – actual) x wt. required sodium for 24 hours Add desired + maintenance Ex : 114+ 40 meq = 154 meq Running rate : < 0. chills fever. may increase to maximum of 0.01 x 3o mins = 4 ml * give for ml to run for 30 mins watchout for nausea.04 ml/kg/min Ex: 12 kg wt Infusion rate of 0.6 x Wt.01-0.02 ml/kg/min for the first 30 mins.1 x 200 = 820mkday) = 100 = 8.9 11-15.6 vials or 10 vials Infusion Rate: 0.5 -1 gm/kg Preparation: 20% 10 gm 25 % 12. Wt x desired ( 4. decreased ST wave . dyspnea. vomiting.5 meq/l A. Ex.Blood Transfusion WHO treatment plan (CDD) Plan A Age in yrs.25-0.3 x base excess Calcium Gluconate Preparation 10% calcium gluconate = 10 g = 100 mg 100 cc ml maintenance = 150-200 mkday Ex.5 gm Transfuse 1 vial to run for 2 hrs at 6-7 gtts/min After 1 vial give furosemide (1 mkdose) Give 2nd vial then furosemide Mobitor VS q 15 mins while ongoing Infusion IVIg Computation # of vials needed = WT. diappearance of P wave 3.actual Na x 0.01 12 kg X 0.6 x 10 kg = 114 meq B. x 4 (constant) Ex. malaise.3 IVIg Preparation Available Serum K if > 6.02 x 60 mins 12 x 0.9 >30 Ml in 4 hours 200-400 400-600 600-800 800-1200 1200-2200 2200-4200 Plan C Age <12 mo >12 mo Using PLR for 4-6 30 ml/kg 1 hr 30 mins hrs 50 ml/kg 5 hrs 2 ½ hours FWB: PRBC: Plt Conc: FFP: Cryoppt: 10 cc/kg 10 cc/kg 1 unit/7 kg 10 – 15 cc/kg 1unit/5 kg 4-6 hours 4 hours fast drip 2-4 hrs How to compute ANC = WBC(% neutrophils + % bands) x 1000 Fluid Balance TFB=Total fluid intake – total fluid output TFI – ( TFO + (BSAxIWL)) TFI = parenteral (IVF/meds) + oral TFO= IWL (400-700/m2) + urine output+ vomitus/ NGT output TFR = BSA x IWL + ½ U. remaining to run for 14 hours Potasium (K) Normal value: 3.5 g = 9.1-0. To compute for maintenance Required K= deficit + maintenance Wt.9 16-29. X 0. To compute for deficit Desired Na (140 meq/l) . <2 2-10 >10 Give every after BM 50-100 ml (2-3oz) 100-200 ml (2-3 0z) As much as tolerated Plan B Age <4 mo 4-11 12-23 mo 2-4y/o 5-10 10-15 y/o Weight <5 kg 5-7. x 0. 140-121 x 0. increase to infusion rate 0f 0. Wt x rate x prep. erythropoeisis.5 = 0. Mal.5 grms x 6 grms kg.5 (wt) (100) 20 gm X = ________ ml q 6-8 hrs Ex. Mal <60% 3rd deg mal. = ml/day 10 kg x 0. x 0.49 (D5050) 59 .5-2 grms/ kg/day Ex. of RBC’s needed wt.49 = 52 cc Reticulocyte Index RI =actual Hct.3-0. for age > 95 % 90-05% 80-90% <80% normal mild mod severe Wasting: Actual wt.U HCO3 (+) = low H+ secretion and low ammonium excretion (-) = urinary bicarbonate loss Nutrition TCR = IBW x RDA for age or TCR = holiday segar method (in kcal/kg) CHON : 2 gm/kg/day Fats: 40% CHO: 60 % divided into 3 meals and 3 snacks Intralipid Ex.11 = 6. hemolysis < 1 dec.5-5 = 50-5 = 0. Ideal wt for ht > 90 % 80-90% 70-80% x 100% normal mild mod Dextrosity: Aminosteril Feeding Rate: 0.100% 2 Urine Anion Gap = urine Na + Urine K – U Cl . x 100% Ideal Ht. x 2 x 85 – actual vol of RBC needed Mannitol (20%) Dose: 0. 61-75% 2nd Deg.45 35-45 80-100 22-26 94. erythropoeisis. (as test dose) then 14 cc to run for 20 hrs via infusion/syringe pump * insert another line * intralipid should not be mixed with electrolyte containing IVF Lipid Dose: 0.Haesteril 6% <10 kg = 10 cc/kg <20 kg = 20 cc/kg > 20 kg = 30 cc/kg/hr Ex: WT: 72. for age 97-100% normal 76-96% 1st deg.lowest x 1 Highest – lowest D10 – D5 = 50-5 D7.2 Wt x dose x 100/ 20 (if 20% prep) * add additional amount of D5W total of 24 cc to run at 1 cc/hr for 24 hrs via syringe pump * wrap tubing with carbon paper Gomez Classification Actual wt.9 Nacl/ D50. Ct.055 = D7.5 45 7.5 /kg = x (gm) x (g) x 100 ml/10 gm = x (cc) To order: start intralipid 10% give __ cc to run for 1 hr.6.7 _____ 2________ Actual vol.5 normal > 1 inc.45 ml/hr Div doses Desired .day 100 ml 5 gms x 100 ml = 83 ml/day day 6 grms = 83 ml = 3.5 = 0. 59 cc x 0. 44kg dose 0.166 = D12.9 = 218 cc/hr = 54-55gtts/min (IVF) (-) 7-8 gtts/min (haes) 4 4 = 47-48 gtts /min (IVF rate) Order: Hook D5 0. (ml) of FFP needed = Wt. BM failure Hypoglycemia premature neonate newborn: 1 day >1 day child fasting 2 hours PP normal glucose value (mg/dl) 20-60 30-60 40-60 50-90 60-100 70-105 <120 Treatment : 2 ml/kg of D10 (bolus) IV bolus .5 45 ABG pH pCO2 pO2 HCO3 O2sat BE +/- 7.3 g/kg 202/100ml x15/x = x (20g) = 15 x 100 x= 1500/20 = 75 ml q6 WT.7.5 – 5 50-5 5 = D12. (ml) of RBC needed WTx2x85 = 0.35.5 g/kg 20 g/100ml x 0.3 to run at47-48 gtts/min Hook 6% haesteril as drip to run at 7-8 gtts per min Excahnge Transfusion total vol (ml) = Wt (kg) x 2 x 85 (bld vol) Absolute vol. X Retic. desired hct 10 normal value: 1-1. inc BM activity. x2 x 85 2 Absolute vol.9 kg x 3 cc/kg/hr x 24 hrs = 720 cc total IVF/day – 720 cc = 4528.5 (wt)/ X = x x= 0.11 = D10 45 2.8 ml 72.5 . Waterlowe Classification Stunting :actual wt.9 kg IVF: 3cc/kg/hr 72. x 100% Ht. 5–4.0 7 32 1650 3.EVALUATION OF TRANSUDATE vs. 1999. PMNs. PERICARDIAL.7 g/L mg/dL Child 5–40 0. EXUDATE (PLEURAL.0 >3. polymorphonuclear lymphocytes.0 7 30 1350 3. Modified from Oski FA: Principles and Practice of Pediatrics.016 Protein (g/dL) <3. TABLE 1-2 -. WBC. Stridor Cough retraction Dyspnea color none audible stridor when agitated at rest severe none when agitated croup like at rest severe rest mild moderate severe none mild moderate severe normal cyanosis at room air cyanosis w/02 score 0 1 2 3 4 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 Hypoxic Ischemic Encephalorathy (Sarnat Scoring) level of conciusness muscle tone myoclonus seizure suck reflex moro reflex grasp dolls eye respi. Croup Scoring Respi.4 mmol/L CSF GLUCOSE/BLOOD GLUCOSE Preterm 55%–105% Term 44%–128% Child 50% LACTIC ACID DEHYDROGENASE Normal range 5–30 U/L (or about 10% of serum value) Preterm PROTEIN 65–150 mg/dL 0.0 7 34 2100 3. N or tachy dilated reactive II lethargy hypotonic III coma failed + + weak inc. cerebrospinal fluid. Philadelphia. white blood cell.05–0. CR pupils I alert normal or hypertonic + active exagerated N or inc N reg. BW = 3 kg 3 x 2 ml = 6 ml 6 x factor = 6 x 0.3 cc of present IVF (or D5W) + 0.20–1.PREDICTED ENDOTRACHEAL TUBE SIZE AND * EXPECTED BIRTH WEIGHT BY GESTATIONAL AGE Gestational Weight ETT Size ETT Depth of Insertion Age (wk) (g) (mm) (cm from upper lip) 24 700 2.5 g/L TABLE 25-2 -.000 Variable Glucose Same as serum Less than serum pH§ 7.0 Fluid : serum ratio <0. JB Lippincott.7 cc of D50-50 to make D10 as bolus Term 20–170 0.4–7.5 mmol/L 1.5 >0.5–3. white blood cells.5 <7.40 g/L mg/dL CSF.Ex.EVALUATION OF CEREBROSPINAL FLUID WBC Count Mean % PMNs Preterm 0–25 57% 3 WBCs/mm Term 0–22 61% WBCs/mm3 Child 0–7 5% WBCs/mm3 Preterm Term Child GLUCOSE 24–63 mg/dL 34–119 mg/dL 40–80 mg/dL 1.9–6. red blood cells. 0r apneic brady aniso nonreact.5 8 38 3000 3. exag.6 mmol/L 2. 3rd ed.4 LDH. lactate dehydrogenase.5 7 26 900 2.2–4.66 cc order: 5.6 >0.MANAGEMENT OF CIRCULATION Location* Rate Compressions: (per min) Ventilation Infants 1 fingerbreadth >100 5:1 below intermammary line Children 2 fingerbreadth 100 5:1 (<8 yr) below intermammary line Older Lower half of 100 15:2 children stemum (>8 yr) TABLE 17-3 -.016 >1. RBCs.5 8 36 2600 3.0 9 INFANT GROWTH AND CALORIC REQUIREMENTS Preterm Infants Term Infants 15–20 g/kg/day 10 g/kg/day Maintaining 50–75 kcal/kg/day weight Adequate 115–130 kcal/kg/day (may be up 100–120 growth to 150 kcal/kg/day for VLBW kcal/kg/day infants) LABORATORY DIFFERENTIATION OF OLIGURIA Test Prerenal Renal FENa <1% >3% BUN/Cr ratio >20 :1 <10 : 1 Urine specific >1. Note: Amylase >5000 U/mL or pleural fluid : serum ratio >1 suggests pancreatitis. WBCs.6 (isoenzymes not useful) WBCs‡ <1000/mm3 >1000/mm3 RBCs <10.5 7 28 1100 2.015 <1.3–3.11 = 0.65–1. OR PERITONEAL FLUID) Measurement* Transudate Exudate† Specific gravity <1. overactivity varies brady aniso reactive + absent dec. TABLE 25-3 -.5 LDH (IU) <200 >200 Fluid : serum ratio <0.010 gravity . 5. strep Pn.GUIDELINES FOR USE OF PHOTOTHERAPY IN PRETERM INFANTS <1 WEEK OF AGE Weight (g) Phototherapy (mg/dL) Transfusion (mg/dL) Consider Exchange 500–1000 5–7 12–15 1000–1500 7–10 15–18 1500–2500 10–15 18–20 >2500 >15 >20 GUIDELINES FOR USE OF PHOTOTHERAPY IN PRETERM INFANTS <1 WEEK OF AGE Weight (g) Phototherapy Transfusion (mg/dL) Consider (mg/dL) Exchange 500–1000 5–7 12–15 1000–1500 7–10 15–18 1500–2500 10–15 18–20 >2500 >15 >20 CALCULATION OF EXPECTED COMPENSATORY RESPONSE Disturbance Primary pH Expected Change Compensatory Response Acute ↑ PaCO2 ↓ pH ↑ HCO3.cyclphophamide 1gm (1000 mg) + 100 ml D5W to run for 1 hour Post chemo/ cyclophosphamide hydration .7 ml sterile water IV push every 10 exchanges > give furosemide after exchange Pulse Cyclophosphamide Therapy ( for Systemic Lupus Erythematosus) Pre hydration: .sterile gloves size_______ .by 1 mEq/L respiratory for each 10 mmHg acidosis rise in PaCO2 Acute ↓ PaCO2 ↑ pH ↓ HCO3. N meningitides) Blood transfusion Orders Secure and transfuse (blood product )to run for hours properly typed and x matched IVF to KVO while ongoing transfusion then Resume present IVF once transfusion is finished watch out for any untoward signs and symptoms such as fever. chills. and post BT (depends sa AP) For exchange transfusion orders Pls. AFB #2 : RBC. therapy Materials for Triple Intrathecal (TIT) > NPO temp.by 1–3 respiratory mEq/L for each 10 alkalosis mmHg fall in PaCO2 Chronic ↑ PaCO2 ↓ pH ↑ HCO3. H. diff ct.2. rashes.1 mg/kg/dose mid For BMA Orders prepare the ff Materials gloves size_____ eye sheet sterile cotton #1 sterile gauze # 2 glass slides #20 syringe 10 cc #2 5cc syringe #1 betadine #1 lidocaine 2% #2 70% alcohol secure consent pls. q30 mins x 2 hours then q 1 till stable >Send CSF Specimen to the lab as ff: bottle #1 : GS/CS. tachycardia hook plain NSS while on BT to run at KVO monitor vs q 15 minutes while ongoing BT give paracetamol __ mg SIVP 1 hr prior to BT Inform PROD once blood product is available For repeat CBC 6 hours post BT (optional) Furosemide at 0. WBC. I influ.same regulation as pre chemo hydration .sterile water 50 ml #1 .maintain on heplock after 10 hrs.limit sodium intake to 2 g/day .sterile gauze .25–1 alkalosis × rise in HCO3Lumbar Tap Orders Please secure consent Prepare the ff materials: Sterile gloves size _____ Disposable needle q 23/24 Sterile Specimen bottles #4 Eye sheet Sterile gauze/cotton Betadine/Alcohol #1 Secure ___________ for sedation For HGT prior to LT Post Lumbar Tap Orders >Flat on bed for 4 hours >NPO temp for 2 hours then may feed once fully awake with aspiration precaution >Monitor VS q 15 min x 1 hour.5 cc syringe #1 >sterile needle g 23 or ___ .5 acidosis × fall in HCO3Metabolic ↑ HCO3 ↑ pH ↑ PaCO2 by 0. DOB. 4 mg +50 ml D5W to run for 30 mins .by 4 mEq/L respiratory for each 10 mmHg acidosis rise in PaCO2 Chronic ↓ PaCO2 ↑ pH ↓ HCO3.Prednisone 20 mg OD after breakfast .I and O q shift .sterile specimen bottle #1 . #3 : protein/sugar #4 phadebact ( test for strep B. TABLE 17-11 -.by 2–5 respiratory mEq/L for each 10 alkalosis mmHg fall in PaCO2 Metabolic ↓ HCO3↓ pH ↓ PaCO2 by 1 to 1.sterile cotton balls .7 ml + 0.ondansetron 4mg + 50 ml D5W for 30mins . materials: .tuberculin syringe #3 .sterile eyesheet . For 4-6 hours > secure consent > prepare the ff.D5W 750 ml to run for 1 hour alternate with D5 0. prepare the following : French 5 feeding tube #2 3 way stopcock syringe connector sterile bottle 1L 10 cc syringe #2 betadine and alcohol sterile cotton sterile gauze #2 suture with needle note: give calcium gluconate 10% 0.TPR q4 and record pls.Ondansetron (zafran) 8 mg/4ml. .3 Nacl 750 ml to run fo for 2 doses . 4 μmol/L 6.4 U/L 7.4–19.5 U/L 0.42 mmol/L 1. and kidney) Infant 150–420 U/L 150–420 U/L 2–10 yr 100–320 U/L 100–320 U/L Adolescent males 100–390 U/L 100–390 U/L Adolescent 100–320 U/L 100–320 U/L females Adult 30–120 U/L 30–120 U/L AMMONIA (Heparinized venous specimen on ice analyzed within 30 min) Newborn 90–150 μg/dL 64–107 μmol/L 0–2 wk 79–129 μg/dL 56–92 μmol/L >1 mo 29–70 μg/dL 21–50 μmol/L Adult 0–50 μg/dL 0–35.9 U/L 1.37 mmol/L 2. and myocardium) Neonate/infant 13–45 13–45 U/L U/L Adult male 10–40 10–40 U/L U/L Adult female 7–35 U/L 7–35 U/L ALDOLASE (Major sources: skeletal muscle and myocardium) 10–24 mo 3.5 U/L ALANINE AMINOTRANSFERASE (ALT) (Major sources: liver.5 mg/dL different reference values) CREATINE KINASE (CREATINE PHOSPHOKINASE) (Major sources: myocardium.2–8.0–11.2 U/L Adult male 0.20–1.40–5.4–11.80–5.7 μmol/L AMYLASE (Major sources: pancreas.6 mg/dL <0.6–10 mg/dL 1. kidney.3–1.8 mg/dL 8. myocardium.8 U/L Adult 1.4–19. smooth muscle.29 Newborn 7. values up to 200 Todd units are normal.6 mmol/L 4.38 mmol/L 1.8–10. skeletal muscle.8 U/L 2–16 yr 1.16–1.0 mg/dL 8.68 mg/dL 4.7 mg/dL 1–2 days <12 mg/dL <11.4–15.7–4.2 mg/dL <34 μmol/L <34 μmol/L <137 μmol/L <149 μmol/L <205 μmol/L <197 μmol/L <274 μmol/L <205 μmol/L <34 μmol/L <21 μmol/L 5–21 μmol/L <10 μmol/L <3.39 96 yr) Adult (>19 7.05–1.2–11 mg/dL 7.48 mg/dL 4.2–2. salivary glands. skeletal muscle.32 mmol/L CHLORIDE (SERUM) 98–113 98–113 mmol/L mEq/L 98–107 98–107 mmol/L mEq/L CHOLESTEROL (see Lipids) C-REACTIVE PROTEIN (Other laboratories may have 0–0.2–9.4–11.3–2.7–4.64–5.2 mg/dL 0.4 mg/dL 9.2 mo–2 yr ACID PHOSPHATASE (Major sources: prostate and erythrocytes) Newborn 7.5 mmol/L 1. skeletal muscle. and erythrocytes) Newborn 25–75 U/L 25–75 U/L Infant 15–60 U/L 15–60 U/L 1–3 yr 20–60 U/L 20–60 U/L 4–6 yr 15–50 U/L 15–50 U/L 7–9 yr 15–40 U/L 15–40 U/L 10–11 yr 10–60 U/L 10–60 U/L 12–19 yr 15–45 U/L 15–45 U/L BICARBONATE Newborn 17–24 mEq/L 17–24 mmol/L >2 yr 16–24 mEq/L 22–26 mEq/L BLOOD GAS.8 mmol/L 2. ASPARTATE AMINOTRANSFERASE (AST) (Major sources: liver. placenta.0 U/L Adult female 0.20–5.35– 90–110 yr) 7.2 mg/dL BILIRUBIN (CONJUGATED) <0.9–2.2–2.26– 60 (birth) 7.2–9. bone. ARTERIAL[7] Pao2(mmHg) pH Newborn 7.8 U/L 3.52 mg/dL 4.7 mmol/L 2.4–15.5–11.40 90 mo) Child (7–19 7.0 U/L 0.28 mg/dL 1.9 U/L ALKALINE PHOSPHATASE (Major sources: liver.10–1.6–10.5–11.8 mmol/L 1.8 U/L 1.4 U/L 2–13 yr 6.5 mg/dL 3–5 days <16 mg/dL <12 mg/dL Older infant <2 mg/dL <1.45 16–24 mmol/L 22–26 mmol/L Paco2(mmHg) HCO3−(mEq/L) 55 19 33 20 34 20 37 22 35–45 22–26 BILIRUBIN (TOTAL) Preterm Term Preterm Term Preterm Term Preterm Term Preterm Term Adult Neonate Infants/children CALCIUM (TOTAL) Preterm Full term <10 days 10 days–24 mo 2–12 yr Adult CALCIUM (IONIZED) Newborn <36 hr Newborn 36–84 hr 1–18 yr Adult Newborn Child/adult Cord <2 mg/dL <2 mg/dL 0–1 days <8 mg/dL <8.37 70 (>24 hr) Infant (1–24 7.2–8.6–2. and brain) Newborn 10–200 U/L 10–200 U/L Man 15–105 U/L 15–105 U/L Woman 10–80 U/L 10–80 U/L . and ovaries) Newborn 5–65 U/L 5–65 U/L Adult 27–131 U/L 27–131 U/L ANTINUCLEAR ANTIBODY (ANA) Not significant <1 : 80 Likely >1 : significant 320 Patterns with clinical correlation: Centromere—CREST Nucleolar—Scleroderma Homogeneous—SLE ANTISTREPTOLYSIN O TITER (4-fold rise in paired serial specimens is significant) Preschool <1 : 85 School age <1 : 170 Older adult <1 : 85 NOTE: Alternatively.2 U/L 6. intestinal mucosa. 7 mEq/L 3.5 mg/dL 1.8–4.3 mmol/L 2.6–1.0–3. erythrocytes.4 mg/dL 0.45–2.4 mg/dL 18–35 μmol/L 0. skeletal muscle.7–5.1–5.9 mmol/L 4.1–3.1 mEq/L PREALBUMIN 7–39 mg/dL 8–34 mg/dL 2–36 mg/dL 12–30 mg/dL 12–42 mg/dL 121–454 μmol/L 73–206 μmol/L 48–109 μmol/L 1.0 mg/dL 4.4–4.8 μmol/L 7.87–1.3 mg/dL 62–115 μmol/L 0.3–0.1–5.7–4.9 mEq/L 4.5% total Hgb <2.8–1. >1 day Child >16 yr HEMOGLOBIN A1 C Adult Newborn Infant Child Adult male Adult female MAGNESIUM METHEMOGLOBIN OSMOLALITY GLUCOSE (SERUM) 20–60 mg/dL 40–60 mg/dL 50–80 mg/dL 60–100 mg/dL 74–106 mg/dL 1.7 mg/dL 4.5–5.0 mEq/L <1.45 mmol/L 3.1–5.7 mg/dL 27–62 μmol/L 0.6 mmol/L LACTATE DEHYDROGENASE (AT 37°C) (Major sources: myocardium.5–6.25 mmol/L 0.0 mmol/L 0.6 mmol/L 4.0 mg/dL 44–88 μmol/L 0.5 mg/dL 2.5–9.5–1.0–7.9–44.5–3. liver.65–1.4–4.5–5.0 mmol/L 275–295 mmol/kg 5–30 mg/L 0.0 mg/dL 27–88 μmol/L 0.2–17.6–1.16 mmol/L 1.3 mEq/L 3.5 μmol/L 11.91 mmol/L 1.Cord Newborn Infant Child Adolescent Man Woman CREATININE (SERUM) 0.7–1.0–30.2 mmol/L 0.9 mmol/L Conventional Units 1.3 mmol/L 2.56–2.7 mmol/L 3.5–5.3–2.0–7.5–2.0–21.5–1.0 IRON 100–250 μg/dL 40–100 μg/dL 50–120 μg/dL 65–175 μg/dL 50–170 μg/dL Quantitative Newborn Infant Child Adult Newborn 1–6 mo 6 mo–4 yr 4–6 yr 6–19 yr High LDL (mg/dL) >200 Desir able <110 Borde rline 110– 129 Hig h >13 0 >240 <100 100– 159 >16 0 PHENYLALANINE 2.2–3.5 mmol/L 3.1 mg/dL 53–97 μmol/L ERYTHROCYTE SEDIMENTATION RATE (ESR) Term neonate 0–4 mm/hr Child 4–20 mm/hr Adult (male) 1–15 mm/hr Adult (female) 4–25 mm/hr Newborn 1 mo 2–5 mo 6 mo–15 yr Adult male Adult female FERRITIN 25–200 ng/mL 200–600 ng/mL 50–200 ng/mL 7–140 ng/mL 20–250 ng/mL 10–120 ng/mL Newborn Infant 2–16 yr >16 yr FOLATE (SERUM) 5–65 ng/mL 15–55 ng/mL 5–21 ng/mL 3–20 ng/mL 20–200 ng/mL 200–600 ng/mL 50–200 ng/mL 7–140 ng/mL 20–250 ng/mL 10–120 ng/mL 11–147 nmol/L 34–125 nmol/L 11–48 nmol/L 7–45 nmol/L γ-GLUTAMYL TRANSFERASE (GGT) (Major sources: liver [biliary tree] and kidney) Cord 19–270 U/L 19–270 U/L Preterm 56–233 U/L 56–233 U/L 0–3 wk 0–130 U/L 0–130 U/L 3 wk–3 mo 4–120 U/L 4–120 U/L 3–12 mo boy 5–65 U/L 5–65 U/L 3–12 mo girl 5–35 U/L 5–35 U/L 1–15 yr 0–23 U/L 0–23 U/L Adult male 11–50 U/L 11–50 U/L Adult female 7–32 U/L 7–32 U/L Preterm Newborn.5% total Hgb 275–295 mOsm/kg KETONES (SERUM) 0.3–1.0 mg/dL Newborn Child LACTATE Capillary blood <27 mg/dL 5–20 mg/dL Venous Arterial 5–20 mg/dL 5–14 mg/dL 17.3–5. <1 day Newborn. platelets.78 mmol/L 0.6–31.9 μmol/L 9. and lymph nodes) 0–4 days 290–775 U/L 290–775 U/L 4–10 days 545–2000 U/L 545–2000 U/L 10 days–24 mo 180–430 U/L 180–430 U/L 24 mo–12 yr 110–295 U/L 110–295 U/L >12 yr 100–190 U/L 100–190 U/L 0–90 days 3–12 mo 1–11 yr >11 yr LIPASE 10–85 U/L 9–128 U/L 10–150 U/L 10–220 U/L LIPIDS [8] Cholesterol (mg/dL) Child/a dolesc ent Adult Desira ble <170 Borde rline 170– 199 <200 200– 239 Preterm Newborn Adult Newborn 10 days–24 mo 24 mo–12 yr >12 yr 5.2–0.1 mmol/L HDL (mg/d L) Desir able 45 45 .5 mg/dL POTASSIUM 3.2–3.4 μmol/L Sl Units 0.45–2.3 mmol/L 3.8 mg/dL PHOSPHORUS 4.7–5.45–1.3 μmol/L 9.2 mg/dL 53–106 μmol/L 0. 9–1.9–71.5) 12 36 10.4 14.10 mmol/L 130–140 mmol/L 133–146 mmol/L TOTAL IRON-BINDING CAPACITY (TIBC) 100–400 μg/dL 17.4 mg/dL 0.6–46.5 (5-15.4–1.5) 11.5 4.14–0.1 μmol/L Newborn 3 mo–10 yr Adult Premature (<1 week) Newborn Infant/child Adult TRANSFERRIN 130–275 mg/dL 203–360 mg/dL 215–380 mg/dL 1.43 mmol/L Adult female 2.9 (9.5 4.03–3.3 mmol/L 1.8 (4-19.5-11) 7.46–1.5 14 47 41 7.15–3.5 6-17.14–0.4–6.8 (4.7 μmol/L 0.2 yr 2 .6 53 11.1 mmol/L URIC ACID 2.5 45 15 47 16.4–5.8–6.5 mg/dL 23–85 μmol/L VITAMIN D3 16–65 pg/mL 42–169 pmol/L VITAMIN E 3–15 mg/L 5–20 mg/L 148–616 pmol/L 7.25-dihydroxyvitamin D) <11 yr >11 yr VITAMIN B1 5.7–18.4 (4.23 μmol/L 106–638 nmol/L VITAMIN B12 (Cobalamin) 160–1300 pg/mL 200–835 pg/mL 118–959 pmol/L VITAMIN C 0.PYRUVATE RHEUMATOID FACTOR SODIUM 130–140 mEq/L 133–146 mEq/L Preterm Older Infant Adult Conventional Units 0.38 mmol/L 2–12 yr 12–14 yr 2.1 ( 9-30) 18.5-13.4–6.3–0.14–0.5-13.5 5-14.3–7.63–1.5 6-17 5.4 (5-20) 13.6 μmol/L 250–425 μg/dL 44.4-34) 16.9 mmol/L 4–12 mg/dL 5–18 mg/dL 1.38 mmol/L 0–2 yr VITAMIN A (Retinol) Preterm Full term 13–46 μg/dL 18–50 μg/dL 0.9 (6-17.4 mg/dL 0.38 mmol/L Adult male 3.20–0.5-11) 150-350 150-350 Wbc 9-30 13-38 9.9 μg/dL VITAMIN B2 4–24 μg/dL 0.6 yr 6 – 12 yr 12 – 18 yr Male Female Adult Male Female Age Birth 12 hrs 24 hrs 1 wk 2 wk 1 mo 6 mo 1 yrs 2 yrs 4 yrs 6 yrs 8 yrs 10 yrs 16 yrs 21 yrs Age specific blood cell indices Hb (g%) Ht WBC 13.5) 150-350 150-350 15.5-15.5 μmol/L (Thiamine) (Riboflavin) Newborn Child/adult (Ascorbic acid) (1.5 40 8.5 14 43 41 7.75 μmol/L 1–6 yr 7–12 yr 13–19 yr 20–43 μg/dL 20–49 μg/dL 26–72 μg/dL 0.4 mmol/L 6–20 mg/dL 2.4–4.1–8.5) Plt 254 (180-327) 275 290 290 192 252 150-350 150-350 150-350 14.6 g/L 2.75 g/L 2.8 (4.16–0.5 56 18.5-13.5 51 18.4 41.1 (4.2 mg/dL 0.9 mg/dL <30 U/mL Sl Units 0.9–2.5 37 8.03–0.8 g/L UREA NITROGEN 3–25 mg/dL 1.4 μmol/L ZINC 70–120 mg/dL 10.5 4.2 35 12.5) 7.35 mmol/L 0.5-11 .8–76.61 μmol/L 0.4–6.5 6-17.9 mg/dL 2.7–1.6 (6-17) 12.5) 13.5 4.6 36 11.4-34 5-21 5-20 5-19.9 44 10.4 mmol/L Age 26-30 wk 28 wk 32 wk Term ( cord ) 1-3 D 2 wk 1 mo 2 mo 6 mo 6 mo .14–0.5 μmol/L 0.0–35 μmol/L 11.4 mg/dL 0.5–7.4 (4.30–2.5-13.1–7.5-13 4.5-13.
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