Slowly

Still not firing on all cylinders yet - motivational issues + obstetric nights! Have managed to finish the paediatric syllabus now, so moving onto obstetrics this week. Below is a paediatric crib sheet which I have copied directly onto my PDA as a useful resource:

Paediatric Crib Sheet

Neonate

-1^st 44wks postconceptual age

-TV = 7ml/kg

-CO = 200ml/kg/min

-Blood vol = 90ml/kg

Infant

-Up to 12 months

-Weight = (Age in months + 9)/2

-TV = 6-8ml/kg

-Blood vol = 85ml/kg

Child

-1-12 years

-Weight = (Age + 4) x 2

-Blood vol = 80ml/kg

-Mean SBP = 90 + (age x 2)

Fluids

-Maintenance: 4ml/kg/hr for 1st 10kg. 2ml/kg/hr for 2nd 10kg. 1ml/kg/hr for subsequent kgs

-4% dextrose/0.18% saline

-Fluid Bolus: 20ml/kg

Equipment

LMA size

1 (0-5kg)-cuff 2-5mls.

1.5 (5-10kg)-5-7mls.

2 (10-20kg)-7-10mls.

2.5 (20-30kg)-12-14mls.

3 (>30kg)-15-20mls.

-Uncuffed until 8-10yrs

ETT size

>2kg = 2.5mm

2-4kg = 3.0mm

Term neonate = 3.5mm

3 months-1yr = 4.0mm

>2yrs = (Age/4) + 4

ETT length

oral (age/2) + 12

nasal (age/2) + 15

-TV= 10mls/kg

-PCV 18-20cmH2O/RR 16-24

-Min FGF 3L

-Insp press = 18-20cmH₂O

-RR = 16-24

Fasting

-Clear fluid 2hrs

-Breast Milk/Formula 4hrs (<12months)

-Solids (& milk) 6hrs

Drugs

-EMLA: 5% lignocaine & 5% prilocaine (45mins)

-Ametop: 4% amethocaine gel (30mins)

-Midazolam 0.1-0.2mg/kg (PO 0.5mg/kg)

-(Flumazenil 5µg/kg incr to 40µg/kg)

-Temazepam 0.5-1mg/kg

-Fentanyl 1-5µg/kg (up to 25µg/kg: cardiac)

-Propofol 2-5mg/kg

-Thiopentone 4-6mg/kg

-(Etomidate 0.3mg/kg (0.1-0.4))

-Ketamine 2mg/kg (5-7mg/kg IM)

-Suxamethonium 2mg/kg

-Atropine 10µg/kg (20µg/kg IM)

-Adrenaline 0.1ml/kg 1:10000 (10µg/kg)

-Atracurium 0.5mg/kg

-Rocuronium 0.6mg/kg

-Vecuronium 0.1mg/kg

-Neo/Glyco 0.02ml/kg

(dilute 1ml w. 4ml saline give 0.1ml/kg).

-Morphine 0.1-0.2mg/kg 4hrly

-Oramorph 0.4mg/kg

(Naloxone 5-10µg/kg)

-Paracetamol 20-30mg/kg loading then 15mg/kg qds

-Diclofenac 1mg/kg tds (max 3mg/kg/day)

-Ibuprofen 5-10mg/kg tds

-Codeine phos 1mg/kg qds

-Cefuroxime 20-30mg/kg tds

-Metronidazole 7.5mg/kg

-Augmentin 25-50mg/kg qds

-Erythromycin 10-25mg/kg

-Cyclizine 1mg/kg

-Dexamethasone 0.15mg/kg

Ondansetron >2yrs 0.1mg/kg

Armitage regime

-0.25% bupivacaine

-Lumbosacral: 0.5ml/kg

-Thoracolumbar: 1ml.kg

-Midthoracic: 1.25ml/kg

Add

-clonidine 1µg/kg,

-diamorphine 30µg/kg,

-PF ketamine 0.5mg/kg,

-PF morphine 50µg/kg

-Wound infiltration 1ml/kg 0.25% bupivacaine

Epidurals

Loading dose:

-0.75ml/kg(lumbar) or 0.5ml/kg(thoracic) of 0.25% bupivacaine

Infusion:

-60ml of 0.125% bupivacaine + 2µg/ml fentanyl

Rate: 0.1-0.4ml/kg/hr