Picu Pocketbook

PICU POCKET CARD ETT size= (Age in years+16)/4 ETT depth from lip/teeth=3xETT size FORMULAE: ! inf"sions# mg dr"g/1$$ml %"id = 1 89A(m.)= 6 x desired dose(m&g/'g/min) x height  ( cm ) ×weight ( kg ) ÷ 3600 √ height  eight('g) esired rate (m*/hr) w eight× height÷ height÷ 60 or √ weight× VASOPRESSORS: . :5; = ' < hei height ght(&m (&m)/ )/ edi&atio edi&atio ose(m&g/' ! 9&reat(mg/d*) = x n g/min) inf"sion ml/min/13m . rate a  = $33 $33 iin n *80> *80> t?1 t?1 opamine ,-.$ 1ml/hr 'g o"tami ,-.$ 1ml/hr  $4, $4, in ter term m A:A A:A ? 1 ne year Adrenaline $1-1 1ml/hr= & $, $,, in (0arm $1m&g/ &hildren/adoles&ent sho&') 'g/min females 2or$$,-. 1ml/hr= d $$ $$ in adol adoles& es&en entt adrenaline $1m&g/ males (old 'g/min 3 7odera 7oderall index index = eight/le eight/length ngth3 sho&') < 1$$ ilrinone ,$-, 4 :; = @ of dextro dextrose se < inf"si inf"sion on mg/'g rate(ml/'g/day) rate(ml/'g /day) /144 loading , 8i&ar 8i&ar &orre& &orre&tion tion## dose a 2eona 2eo nate= te=$6 $6 x $.,-1 eight(98E-) mg/'g/min  2on-n 2on-neon eonate ate=$ =$3 3x SEDATION by infusion: eight(98E-) idazolam 1-3 m&g/'g/min & :iBe :iBe half half dose dose stat stat and 5entanyl 1-, m&g/'g/hr(1$$"g/ml ine&tion) remaining in diBided 7ropofol 1-. mg/'g/hr doses in !5 orphine $1-$. mg/'g/hr after a ol"s of $1 mg/'g d 9tat dose as 1-. mEC/'g mEC/'g (1$mg/ml ine&tion) Atra&"ri"m $, mg/'g $3-$, mg/'g/min 

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6 9odi"m 9odi"m &orr &orre&tio e&tion n = $6 < eight < sodi"m deD&it ANTIBIOTICS: 1 AA AA2# 2# 1,-.$m 1,-.$mg/'g g/'g/d /d 1. hr> neonates till  days F . :E2TA :E2TA2# 2# ,$mg/ ,$mg/'g/d 'g/d 1hr 3 E5F7E; E5F7E;AGF2 AGF2E/9H E/9H*8A *8ATH TH( ( A:2E Ldays11yr M Ch .$TEF7*A22# 1$mg/'g C1.h x 3 doses 1$mg/'g/d F .1!A2FJ2# 1$mg/'g/dose C6h> meningitis M 1,mg/'g/dose C6h ..7F*J$$$ "nits/'g C1.h ANTICONVULSANTS: 1 AGE7A# $.-$, mg/'g/dose L1 month of age> max ,mg for ?, yrs> 1$mg for L,yrs . *F;AGE7A# $$,-$1 mg/'g/dose > max 4 mg 3 7KE2F8A;8TF2E# *oading 1,-.$ mg/'g at 1mg/'g/min> &an giBe ,mg/'g till max 3$ mg/'g aintenan&e 3-, mg/'g/d C1.h or K9 F 4 7KE2JTF2# loading dose1,-.$ mg/'g/d at 1mg/'g/min maintianen&e dose ,N mg/'g/d C-1.h , !A*7;FATE# loading .$ mg/'g ,-1$ mg/'g/dose Ch SEDATION FOR PROCEDURES: 

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1 AGF*A# $. mg/'g/dose> max 6mg> in&rements of .,@ of initial dose . 5F;T02# 1 mg/'g/dose 3 7KE2A;:A2# 1 mg/'g/dose   OTHERS: 1 ;A2TA# 1 mg/'g/dose K !> C1.K 7F . *A9 ranging "p to 1 se&ond in older 'ids 3 ;ate (!)- age appropriate 3$ (infants) don to 1,( ad"lt sized patients) to start 4 Tidal Bol"me (!t) - 1$ml/'g ro"nding don then loo' at &hest rise> listen for reath so"nds and &he&' 7ea' nspiratory 7ress"re (77) , e&rease !t 5 exam reBeals ex&essiBe &hest rise> large air entry and higher than expe&ted 77s (?3$3, &m K.$) EleBated 77s may res"lt from ; main stem ET t"e pla&ement> m"&o"s pl"gging> ex&essiBe !t or poor l"ng &omplian&e> ie 1O p"lmonary disease 9trongly &onsider sit&hing to press"re &ontrol style reath for seBere l"ng disease 6 n&rease !t 5 exam reBeals poor &hest rise> minimal air entry and loer than expe&ted 77s (?1, &m K.$) 8e aare that ad"lt size Bentilator &ir&"its may gole large amo"nts of Bol"me ea&h reath (.-3 &&/ eBery &m K.F press"re diPeren&e eteen 77 and 7EE7) f this o&&"rs in&rease !t or &hange to a press"re &ontrol style reath  7EE7 - 4&m> higher if 5; &ompromised y atele&tasis> adominal distension or seBere l"ng disease n&rease in .&m K.F

aliC"ots !ol"me re&r"itment ith 7EE7 ta'es ho"rs "t &an e lost in min"tes  7ress"re 9"pport (79)- (f aBailale) for spontaneo"s reathing patients 79 starts at 1$ &m K.F I A8: to a&&"rately a&&ess Bentilation stat"s 1$  and improBes oxygenation for any giBen !t 9trongly &onsider press"re Bentilation (if aBailale) for large air lea's d"e to small ET t"e size> inePe&tiBe Bentilation .O ad"lt Bent &ir&"it on small infant/&hild> or poor l"ng &omplian&e 3 9et 7ress"re &ontrol to giBe ePe&tiBe &hest rise and aCed"ate air entry Expe&t 77s 1-.. &m K.F in patients ith healthy l"ngs> .3-. &m K.F for moderate l"ng disease>

.-3, &m K.F in more seBere disease 4 Fn&e 7 is estalished> loo' at ma&hine meas"red inspiratory and expiratory Bol"mes as an estimate of  patients l"ng &omplian&e !ol"mes sho"ld e ?1$ml/'g to aBoid oBerstret&h Si')% P#ob%' so%*in&: 0hen a Bentilated patient a&"tely deteriorates donQt e aR D islodged ET T"e- &he&' for eC"al reath so"nds> EtF. S> O str"&ted M "&o"s pl"g> s"&tion P ne"mothorax- &he&' for eC"al reath so"nds> needle &ompression Bs  hand ag> &onDrm 1$$@ F. is  %oing S"#a"&is fo# 'o# Co')%+ )#ob%'s: Kypoxemia# goal is to ean 5F. ? ,$@ 1 inimize airlea' y pla&ing larger Et t"e> y repositioning head or &hanging to press"re mode . n&rease 7EE7 in .&m K.F in&rements to in&rease f"n&tional resid"al &apa&ity (Aerated l"ng Bol"me) onsider paralyti&s for 7EE7 L 1$

3 n&rease  time to in&rease ean Airay press"re 4 n&rease ;ate espe&ially if 7F. is eleBated as ell and there is need to in&rease min"te Bentilation , hanging to 7ress"re &ontrol ill res"lt in improBed oxygenation for the same Bol"me deliBered 6 Fn&e the appropriate !t is estalished> re&ommend against &hanging Bol"mes n A;9 Bentilator ind"&ed l"ng in"ry is asso&iated ith  TB L -1$ ml/'g Hi&$ Pa, P#ssu#s: (L3, &mK.F or platea" press"re L 3$ &m K.F) 1 9"&tion Et t"e . he&' t"e position ith  onsider steroids 1. ho"rs prior if me&hani&al Bentilation L4O or after m"ltiple airay int"ations P ress"res - 77 ?.,> 7EE7 ? , P#!ic"o#s of E+"uba"ion Fai%u# !ariale *o ris' ?1$@ Kigh ;is' L.,@  TB spontaneo"s L6, ml/'g ?3, ml/'g

5F. ?$3$ L$4$ 77 ?.,&mK.$ L3$&mK.$