Pharm

Emergency Pediatric Dosing 5 kilogram

search

Emergency Pediatric Dosing 5 kilogram, Broselow Grey 5 kg

  • Criteria
  • Body habitus
  1. Age: 0-2 months
  2. Length: 57-61 cm
  3. Weight: 5 kg
  1. Heart Rate: 120-180/minute
  2. Respiratory Rate: 40-60/minute
  3. Systolic Blood Pressure: 65-95 mmHg
  1. Pretreatment
    1. Atropine 0.1 mg
  2. Induction (Sedation)
    1. Etomidate 1.5 mg
    2. Ketamine 10 mg
    3. Propofol 15 mg
  3. Paralytic
    1. Succinylcholine 10 mg
    2. Rocuronium 5 mg
    3. Vecuronium 0.5 mg
  4. Sedation Maintenance
    1. Lorazepam 0.25 mg
  5. Equipment
    1. ET Size cuffed (preferred): 3.0 mm
    2. ET Size uncuffed: 3.5 mm
    3. ET Insertion depth (at lips): 10-10.5 cm
    4. Laryngoscope Blade: 1 Miller (straight)
    5. Suction catheter: 8 F
    6. LMA: 1
    7. Tidal Volume: 30-50 cc
    8. Breath rate: 20-25/min
    9. Inspiratory time: 0.6 sec
  • Protocol
  • Miscellaneous Equipment
  • Protocol
  • Fluids
  1. IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 100 ml
  2. IV Fluid Crystalloid Maintenance: 20 ml/h
  1. Cardioversion
    1. First (1 J/kg): 5 J
    2. Next (2 J/kg): 10 J
  2. Defibrillation
    1. First (2 J/kg): 10 J
    2. Next (4 J/kg): 20 J
    3. Next (4-10 J/kg): 20-50 J
  3. Lidocaine
    1. Intravenous (100 mg/5 ml = 2%): 5 mg (0.25 ml)
    2. Endotracheal (100 mg/5 ml = 2%): 10-15 mg (0.5 to 0.75 ml)
  4. Epinephrine
    1. Intravenous (1:10,000): 0.05 mg (0.5 ml)
    2. Endotracheal (1:1000): 0.5 mg (0.5 ml)
  5. Atropine
    1. Intravenous (0.1 mg/ml): 0.1 mg (1 ml)
    2. Endotracheal (0.4 mg/ml) 0.25 mg (0.63 ml)
  6. Naloxone
    1. Intravenous (0.4 mg/ml) 0.05 mg (0.13 ml)
    2. Endotracheal (0.4 mg/ml) 0.05 mg (0.13 ml)
  7. Adenosine
    1. Initial dose (6 mg/2ml): 0.5 mg (0.17 ml)
    2. Next dose (6 mg/2ml): 1.0 mg (0.33 ml)
  8. Amiodarone
    1. Intravenous (50 mg/ml): 25 mg (0.5 ml)
  9. Calcium Chloride
    1. Intravenous (100 mg/ml = 10%): 100 mg (1.0 ml)
  10. Magnesium Sulfate
    1. Intravenous (5 g/10 ml = 500 mg/ml = 4 meq Mg/ml = 50%) 250 mg (0.5 ml)
  11. Sodium Bicarbonate (use 4.2% bicarbonate for under age 3 months)
    1. Intravenous (2.5 meq/5ml = 42 mg/ml = 4.2%) 5 meq (10 ml)
  • References
  1. eBroselow
    1. http://www.ebroselow.com
  2. Broselow (2011) Broselow Pediatric Emergency Tape, Vital Signs, Inc, Totowa, NJ
  3. LA County EMS Color Coded Pediatric Drugs
    1. http://ems.dhs.lacounty.gov/ManualsProtocols/3colordrug.pdf
  4. Difficult Airway Course
    1. http://www.theairwaysite.com
  5. (2008) Fairview University - Childrens Hospital, Pediatric Emergency Drug Guide