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EMERGENCY DRUGS CEPHALOSPORINS AMINOGLYCOSIDES Cotrimoxazole 8-10 mkD bid (TMP)

Kindoprim 40/5
st
Epinephrine 0.01 mkd 1 Generation Amikacin 10-15 mkD Bacidal 80/5
Atropine 0.02-0.03 mkd Cephalexin 50-100 mkD q6 Amikacide 100/2; 250/2 Trizole 80/5
Adenocard 6 mg initially; 12mg nxt Cefadroxil 25-50 mkD BID Kanamycin 30-50 mkD Triglobe 45/5
Adenosine 6mg/2mL Cefalothin 50-100 mkD QID Netilmycin 6-8 mkD Bactrim 160/5; 40; 80
Ca Gluc 10% 0.1-0.2 mkd Cefazolin 50-100 mkD QID Nettomycin 50/2 Lidaprim 40/5
Captopril 0.3-1.0 mkD q 12 Cephradine 25-50 mkD q6 Tobramycin 6-8 mkD (Nebcin) Macrobid 40/5
Capoten 25mg/tab Gentamycin 5-8 mkD IV Clindamycin >1mo – 20-40 mkD q 6-8
nd
Hydralazine 0.1-0.5 mkd 2 Generation Garamycin 20mg; 40mg; 80 <1mo- 15-20 mkD q6-8h
Apresoline PO: 10mg; 25 Cefamandole 50-100 QID Dalacin C 75/5ml
IV: 20mg/amp Cefaclor 20-40 mkD q12 Chloramphenicol 50-100 mkD
L-Carnitine 30-40 mkd Ceclor 125/5; 250/5 DS ANTI-AMOEBIC Chloromycetin (Men: 100 mkd
Carnicor PO: 1/10; 330 Cefuroxime IV: 50-100 mkD q8 Metronidazole 40-50 mkD (7.5 mkd) Chloramol q 6H)
IV: 1/5 PO: 20-40 mkD BID < 7 or > 2q = 7 mkD Tetracycline 40-60 mkD
Lidocaine 1.0 mkd bolus Zinnat 125/5,250/5 > 7 or > 2 g = 30 mkD
10-50 ugKm Zinacef IV Flagyl PO: 125/5; 250 MACROLIDES
Mannitol 20% 1-2 mkd IV: 500/100
rd
Prep 1.2% soln (1 med/mL) 3 Generation Metroxyn 500mg Erythromycin 30-50 mkD
NaHCO3 1.5-2.0 mkd Cefotaxime 50-100 mkD BID-QID Servizole 200mg/5mL Erythrocin 200/5; 400/5 ds;
Naloxone 0.1 mkd NB: 50 mkd q 12H Tinidazole 50-60 mg OD x 3 days (AGE) 100/2.5gtts
Plain 0.4mg/1mL 1g bid for > 12yo & adults 50-60 mg x 5 days (liver) Azithromycin 10 mkD ODx3 d
Neonatal 0.02mg/1mL Claforan 500mg; 1g; 2g Etofamide 15-20 mkD Clarithromycin 15 mkD q12 or
Nifedipine 0.2-1.0 mkd Ceftriaxone Child: 20-80 mkD OD Kitnos 40/5; 250; 500 7.5 mkd
Nipride 0.5-1.5 ugkm Adult: 1-2 g OD Furazolidone 5-7 MKD q6 Klaricid 125/5 (don’t ref)
Urecholine 2.9mg/m2/d q8 PO Rocephin

ANTI-STAPH Ceftazidime 50-100 mkD ANTI-TB


(Fortum) < 2mo: 25-50 mkD BID INH Tx: 15-20 mkD liver ANTI-FUNGAL
Nafcillin 100-200 mkD q6 > 2mo: 30-100 mkD TID Px: 10-15 mkD peri. neuritis
Vigopen 250/5 Adult: 1-6 g/day TID Trisovit 50/5 Nystatin 0.5-1mL tid-qid x 7d (thrush)
Co-Amoxiclav 40-60 mkD Cefoperazone 100-150 mkD Nicetal 100/5 NB: 400 TU/day
Augmentin 156/5; 312/5 Child: 50-200 mkD BID Primafort 100/5 Inf/child: 1-2 MU/d
Stafloxin 100-200 mkD Adult: 2-4 gkD q12 Odinah 150/5 Mycostatin 100 TU/mL
Vancomycin 40-60 mkD Cefobis Trisofort 200/5 500 TU/tab
Cloxacillin 50-100 mkD q6 Cefoxitin 50-100 mkD q6-12 Pyrobin H 150/5 Amphotericin B 0.3-0.7 MKD
Prostaphlin-A 125/5 Mefoxin 1 g/vial Comprilex 200/5 500mg + 10mL dist H2O
Orbenin 250; 500 Ceftizoxime Child: 40-80 mkD bid-qid Ethambutol 15-25 mkD optic neuritis Griseofulvin 10 mk SD
Oxacillin 100-200 mkD IV Adult: 0.5-2 g/d Myambutol 200/5 Adult: 500-1000mg/day but not
(Prostaphlin) 2-4 doses IV/IM Ethambin 125/5 <10mkd single or div. doses
Cefixime 3-6 mkD BID Isoetham 150/5 Child: 10 mkD in div. doses
OTHER B-LACTAMS Tergicef 100/5 (50mg/ml) Ethambin/INH 150/5; 125 Grisovin 125 mg/tab
Cefdinir 9-18 mkD q8 Rifampicin 10-20 mkD (liver) Fluconazole LD: 6 MKD
Imepenem 60 mkD q6 Omnicef 50mg/sachet; Rimactane 100/5; 200/5 MD: 3 mkD x 1 week
NB: 20 mk q 12 100mg/cap 150; 300; 450; 600 Diflucan 50mg/cap
Piperacillin (Cypercil) Cedax 9 mkD OD (180/5) Meningo Px: Ketoconazole
Less Serious: 100-200 MKD q6 Cefetamet 20 mkD OD q12 Adult: 600 q12 x 4 doses Nizoral 200mg/tab
Serious: 200-300 MKD Globocef 250/5 1-12yo: 10 mk q12 x 4 doses Terbutafine HCl 1 tab OD
th
Vancomycin 40-60 MKD (give in 2h) 4 Generation 3mo-1y: 5 mk q12 x 4 doses Lamisil 250mg/tab;
Cefepime Streptomycin 20-30 mkD OD IM ototoxic
for severe infection, q8 PZA 30-50 mkD q8
2mo old, BW <40kg = 50 mkq12x10d
ANTI-HELMINTHIC ANTACIDS
ANALGESICS PENICILLINS Oxantel pamoate 10-20 mkd Cimetidine 10-20 mkD q12
Quantrel 100/5; 100 Tagamet Syr: 200/1; 100/5
Fentanyl Low: 2 mkD PCN: 50-100TUKD or Tetramizole 2.5-5 mkd SD Tab: 200; 400; 800
Mod: 2-20 mkD 25-30 mkD TMZ 25mg/10mL IV: 200/2
High: 2-50 mkD 625mg = 1 MU Mebendazole 100 mkd BID x 3 days Ranitidine 4-5 mkD q8
Sublimaze (Janssen): 50ug/2mL 250/5 = 400 TU Antiox: 100; 500mg/tab; 20mg susp Zantac IV: 50/2
Ibuprofen 5-10 mkd q6-8 312.5/5= 500 TU Combantrin 125mg; 250mg/tab PO: 150; 300; 15/1
Dolan FP 100/5 500mg = 800 TU 125mg/5mL susp Cisapride 0.2 mkd q8
Mefenamic acid 3-5 mkD Oral PCN 100-200 TUKD >15yo = 500 mg Prepulsid 1/1; 0.2 mkD TID
Ponstan 50/5 Pentacillin 50/5; 500mg 10-14yo = 375 mg Omeprazole
Midazolam 0.1 mkD Sumapen 25/5; 250; 500 5-9 yo = 250 mg Losec 20mg; 40mg
Dormicum IV: 5/1;5/5;15/3 Megapen 50 TU/mL gtts 5 yo = 125 mg Famotidine 0.7 md q 12
PO: 5mg/tab 312.5/5; 625mg H2 Bloc 20/2
Morphine 0.1-0.2 mkD Amoxicillin 40-60 mkD q8 ANTI-VIRAL Lanzoprazole 25 mg OD PO
Morphine 10/mL Methisoprinol 50-100 mkD Prevacid FDT
Nalbuphine 0.1 mkD Nafcillin 100-200 mkDq6 Isoprinosine 250/1; 500
Nubain 10/mL Stafloxin 100-200 mkD Inosiplex 50 mkD ANTI-SPASMODIC
Pancuronium 0.04-0.1 mkD Ampicillin 100-200 mkD Immunosine 250/5 Relestal 1 mkd (5/1; 10/5)
Promethazine (NB: 50-100 BID; Amantadine 5-8 mkD Bentyl 10/5; 10 mg
Phenergan IV: 50/2 men: 300-400 mkd q6) Symmetrel 50/5 Buscopan 1-3 tab TID; 1-2 tsp TID
PO: 1/1; 10mg Ampicin/Pentrexyl/Aldribid Virazole 10 mkD PO: 5/5; 10mg
Bacampicillin 25-50 mkD Acyclovir 10-15 mkD q6 x 5D IV: 25mg/amp
Penglobe 200/5 Zovirax 250/5; 200 Metoclopromide 0.1 mkd q8H
(0.1-0.2 mkd up to 4x/D)

ANTI-ASTHMA ANTI-DERMATOSES COUGH ANTI-CONVULSANTS


Aminophylline LD: 8-10 mk
MD: 3-5 Hydrocortisone 1% TID x 2 wks Ambroxol 1.2-1.6 mkD q12 Carbamazepine 10-20 mkD
Drip: 0.4-0.9 mkH Hytone/Hydrotpic/Eczacort Mucosulvan 15/5; 7.5/1.5 Tegretol 100/5; 200mg
Noenate: 1 mkd q8 or 2 mkd q12 Betamethasone BID-TID Zobrixol 15/5; 7.5/1.25 Clonazepam 0.01-0.03 mkD
Apnea: LD: 5-6 mkd Betnovate/Diprolene/Diprosone Salvotran 15/5; 30/5 For Dr. Bael: LD: 0.03 MK
MD: 2 mk 12h post-LD Fluocinolone acetonide BID-TID Bromhexine 7-12y = 1 tsp TID MD: 0.08 mkD q12
Prep: 250/10 Aplosyn 10; 25; HP 2-6y = ½ tsp TID Rivotril 2mg/tab
Drip: eg: 5kg at 0.4 mkH in 8h drip: Synalar 10; 25; HP Bromulex 4mg/5mL; 8mg Diazepam 0.2-0.4 mkd (max:2-5mg)
5 x 0.4 x 8 = 16mg in 8h Mometasone furoate OD SCMC 20-30 mkD Valium 10mg/2mL
if IVF rate is 5cc/h, fill soluset Elica/Momate Loviscol 50/1; 100/5 Lorazepam 0.05-0.1 mkd (max: 0.4 MK)
with 40cc IVF+ 16mg Clobetasole propionate Solmux 40/1; 200/5 Midazolam 0.1-0.2 mkd (Domicum)
Amino (0.64mL) Dermovate Cemetol 200/5 Phenobarbital LD: 15-20 mk
Theophylline 3-5 mkd Diflucortolone valerate BID-TID MD: 5 mkD
Nuellin 80/15; 50; 125; 250 Nensona Luminal IV: 130mg/1mL
Terbutaline SQ: 0.005 mkd Desoximetasone BID-TID PO: 20mg/5mL
PO: 0.075 mkd Esperson DIAZEPAM DRIP Gr 1: 65 mg (Gr 1, ½, ¼)
Drip: 0.003 mkH Triamcinolone acetonide BID-TID Phenytoin LD: 15-20 mk
Bricanyl IV: 0.5/1 Kenacort A/Ladercort A 0.3 mkH dilute in NSS makes 0.1mg/mL MD: 5-8 mkD
PO: 1.5/5; 2.5 conc = mg/total vol (mL Dilantin IV: 100mg/2mL
Salbutamol 0.12-0.15 mkd PO: 30/5; 125/5; 30; 100
Ventolin 2/5 sy; 1.2/5 exp; 2 Valproic acid 15 mkD
Librentin 2/5; 2mg Depakene 250mg/5mL
Prox-S 2/5; 2mg Epival 250mg/tab
Atrovent 4-8gtts/mL NSS
ANTI-HISTAMINES DIURETICS Prep: Dopamine: 200/5 Heparin LD: 50 UK IV bolus
Diphenhydramine 3-5 mkD TID-QID Conc Dopa D5W MD: 10-20 Ukh
Benadryl IV: 50/1x3 dose Furosemide 1.0-2.0 mkd S 800 1 cc 49 cc Heparin Lock 0.5-1 U/mL NSS or
PO: 12.5; 25; 50 Lasix 20/2; 40mg DS 1600 2 cc 48 cc 0.02mL/50mL NSS
Methdilazine 0.3 mkD q12-q6 Frusema 20/2; 20mg; 40 QS 3200 4 cc 46 cc HepB IgG 0.5mL/K w/n 12h of birth
Tacaryl 4/5; 4; 8 Diazoxide 5-10 mkd then at 3 & 6 mos if
Clemastine 0.05 mkD q12 Diazoxide 300/2 Prep: Dobutamine: 250/2 vaccine not given
Tavegyl 0.5/5; 1mg Acetazolamide 20-30 mkD Conc Dobu D5W Hep B Vaccine 0.5 mL IM
Hydroxyzine 1 mkD Diamox 250mg/tab S 1000 4cc 46 cc
Iterax 2mg/ml; 10; 25 Spironolactone 1.5-3.0 mkD DS 2000 8 cc 42 cc
Cetirizine 0.25 mkD Aldactone 25mg/tab QS 4000 16 cc 34 cc Indomethacin IV (12-24h interval)
Virlix 10mg/1mL Hydrochlorothiazide 1-2 mkD Initial: 0.2 mk
nd
Loratadine 2-12yo, < 30k: 1 tsp OD Dichlotride 25mg; 50mg/tab Computation for concentration: 2 Dose: < 48h: 0.1 mk
>30k: 2 tsp OD Mannitol 20% 1.5-2 gkD or 5cckd 2-7dy: 0.2 mk
Claritin 5mg/5mL 200g/1L; (1gm = 5 cc; 0.5-1gkd) 1. D5W 250 + 200 mg/amp > 8 dy: 0.25 mk
rd
Ketotifen 0.025 mkd q12 200/250 = 0.8 mg/cc = 800 ug/cc 3 Dose: < 48h: 0.1 mk
Zadec 1mg/5mL; 1mg 1 cc = 60 ugtts 2-7 dy: 0.2 mk
Zaditen 0.2mg/1mL; 1 DOPAMINE DRIP conc = 600/60 = 13.33 ug/ugtts > 8 dy: 0.25 mk
2. Lidocaine 2%
ATROPINE SULFATE 1-5 ug/k/min = VD, inc renal & splan circ 2 g/100 mL = 20 mg/mL Methyldopa 5-40 mkD q6-8
Pedia 1-2 mg SQ q 20min 5-10ug/k/min = inotropic; no effect on HR Aldomet 125; 250
0.2 Mkd q 3-5min 10-20 ug/k/min = inc BP AD = rate x conc Rate = RD x Wt x 60
Adult 2mg q 10 min IV/IM Wt x 60 Conc
0.5mg (5mL) q 3-5min
Mkd PRN after 24h

STEROIDS ELECTROLYTES PARACETAMOL 10-15 mkd INTRALIPID

Dexamethasone 0.2-0.4 mkd Vitamin K 0.3 Mkd (max 5 mg) x 3 dys Aeknil 300mg/2mL 10% = 10 g/100 mL
Decadron 4/1 Afebrin 120mg/5mL; 325mg; 500 20% = 20 g/100 mL (180cal/100ml)
Hydrocortisone LD: 10 mk Calcium gluconate 10% 1 cc/k/shift Biogesic 100mg/1ml; 250/5; 500
MD: 5 mkD IV MD: 200-500MKD q6 or drip Calpol 120mg/5mL; 250mg/5mL eg: Wt = 2k at intra dose=0.5 gkD (10%)
Solu-cortef 100/2; 250/2 (Max 200 Mkd in 10 min) Crocin 125mg/5mL; 500mg 2 kg x 0.5 x 100 = 10 mL (of 10% IL)
Act-o-vial 100 IV: 100/1 (9 el. Ca/ml or 0.45mg Defebrol 60mg/0.6mL; 120mg/5mL 10
Prednisolone 0.7 mkD Ca/ml) Naprex 250mg/5m; 500mg
Solumedrol 125/2 PO: 500 mg (45 mg Ca) Opigesic 125mg; 250mg
Prednisone 0.5 mkD 650 mg (58.5 mg Ca) Rexidol 150mg/5mL; 60/0.06; 600 VAMIN/AMINOSTERIL
1 mkD (BA) Tempra 120mg/5mL; 60mg/0.06mL
Iron Tx: 4-6 MKD Tylenol 120mg/5mL CHON: 2.5-4 Gkd Amino 6%
Px: 1-2 MKD Winadol 120mg/5mL; 500mg Glucose: 5-9 MK
ALBUMIN Iberet 500 mg (26.25 elem Fe) Prep. per liter: CHON : 60 g
Odiron 50mg/10mL; 25mg/5mL SALICYLATES Calories : 650 cal
Albumin: 1 g/K/dose Fer-in-sol 15mg/0.6ml; 18mg/5mL Glucose : 100 g
Alburein 12.5g/50mL (25%) Propan 25mg/5mL Anti-rheumatic 65-130 mkD start dose at CHON = 0.5 gKD
Ferlin 30mg/5mL; 15mg/1mL Asaped 81mg eg: wt = 1kg
Formula: Desired-Actual x 1.2 x Wt Incremin 30mg/5mL Ascriptin 325mg 1 kg x 0.5 x 1000
Albumin 0.5-1.0 g/K (max 6 gKD) Polyvifer 10mg/1mL Aspirin Gr V Gr 1 = 65 mg 60
Albumer/Albutein 50/1 (5%) Neo-Novaldin 325mg = 8.3 cc Vamin/12h
250/1 (25%) Glucagon 0.25-0.3 mkd Superin 180mg/5mL; 3g
0.3 mkd-1mg in IDM
1 mg (1 “U”) vial
LUMBAR TAP HS METHOD for IVF Infusion BALLARD’S MATURITY TESTING DIGITALIZATION
Pressure (in cmH2O)
G 22 (1 ½) = gtts in 21 sec 2.5-10kg 100cc/k/day Score AOG (wks) Digitalis 0.04-0.06 mk (TDD)
G 22 (3 ½) = gtta in 39 sec 10-20kg 1000cc+50cc/k over 10k Pedia Elxr 0.05/ml; 0.25/ml
G 20 (3 ½) = gtts in 12 sec >20kg 1500cc+20cc/k over 20k 5 26 PO: 0.25mg/tab
10 28 IV: 0.5mg/2mL amp
WBC correction in traumatic tap: TF/4 = cc/hr or ugtt/min 15 30
Periph WBC x 1000 = WBC 20 32 TDD = 0.04-0.06 Mk
st
5,000,000 1000 RBC Phototx +20% 25 34 1 dose = ½ TDD
nd
Tachypnea +25-50% 30 36 2 dose = ¼ TDD (8hrs)
o o rd
C/I: increased ICP Fever +12% q 1 C > 37.5 C 35 38 3 dose = ¼ TDD (6 hrs)
severe CP depression Hypermetabolic +25-50% 40 40 12H after, start MD = 1/5 of TDD OD
st
infected skin Burns +14% for 1 Degree 45 42 = 1/10 of TDD BID
decreased platelet count or blood d/o Sweating +10-25% 50 44
brain abscess Adult: TDD: 0.5-1.5 Mkd
CHARACTERISTICS OF MD: 0.125-0.25 Md
PROXIMAL & DISTAL SBO
PHOTOTHERAPY KVO: ugtt = 3.5
Indication: PT: 10 mg% bilirubin gtt = 10 HIGH SBO LOW SBO Cafeine Na benzoate 0.1-0.2 cc IM
FT: 15 mg% bilirubin Acute onset less acute Prep 5mg/ml; 10mg/mL
Complications: Prominent vomiting less prominent
osmotic diarrhea Vomit not feculent often feculent Nelson’s: ½ TDD – immediately
rashes Pain frequent less frequent ¼ TDD – 12H after
bronze baby syndrome minimal distension prominent ¼ TDD – 12H after
dehydration ¼ TDD in 2 doses (q 12H) as MD

SA = Wt x 4 + 7 x 400 (renal) RANSON’S CRITERIA for CRITERIA FOR AMI GLUCOSE INFUSION RATE
Wt + 90 ACUTE PANCREATITIS
1.typical pain: retrosternal, severe, pain GIR = Rate x Dextrosity
Men SA x 1500 On Admission: lasting >30min, unrelieved by nitrates, Wt x 60
Preterm SA x 1200 cold, clammy perspiration Dextrosity: D5 50
CHF SA x 800 1. age > 55 yrs 2. evolutionary ST elevation followed by D7.5 75
Cardiac SA x 200 2. leukocytosis > 16,000 Q wave formation and ST segment D10 100
Renal SA x 400 + 24h UO 3. hyperglycemia > 200mg/dL inversion D50 500
MF < 2yo = SA x 1500 (11mmol/L) 3. elevation of serum CPK-MB Conversion:
> 2yo = SA x 1200 4. serum LDH > 400 IU/L conc desired-actual x 2 x total vol
5. serum AST > 250 IU/L Labs: 100
0-5 kg wt x 0.05 + 0.05 Onset Peak Duration eg: D10 – D5 x 2 = 0.1
6-10 kg wt x 0.04 + 0.1 During the initial 48hrs: CPK-MB 4-6h 12-24h 24-48h 100
10-15k wt x 0.03 + 0.2 SGOT 8-12h 36-48h 3-5days if total vol = 100 cc:
15-20k wt x 0.02 + 0.3 1. hematocrit fall > 10% LDH 12-24h 2-4days 7-10days 100 x 0.1 = 10cc D50W
2. fluid sequestration > 4000 mL + 90cc D5 IVF
CRITERIA FOR RHEUMATIC FEVER 3. hypocalcemia < 8mg/dL (1.9mmol/L) = 100cc of D10 IVF
4. hypoxemia (PO2 <60mmHg) thus: 100cc/k/day divided by 3 shifts
Major: carditis, polyarthritis, chorea, 5. BUN rise >1.85mg/dL (>1.8mmol/L) = x 10% = D50 in sol
subcutaneous nodules, erythema marginatum post IVF To convert to: D7.5 = x 0.055
6. hypoalbuminemia < 3.2g/dL (32g/L) D10 = x 0.11
Minor: hx of RF/RHD, arthralgia, fever, D12.5= x 0.16
elevated ASO, CRP & ESR, prolonged Calorie in IVF: D5 = x 0.2
PR interval, (+) culture of Grp. A strep D7.5 = x 0.3
D10 = x 0.4
D12 = x 0.5
H=  24 x pCO2 CPAP ABG HYPERBIL MGT
HCO3 HEALTHY TERM NEONATE
TFR = wt x TV(10-15) x RR x IE ratio(2) pH 7.35-7.45 = 7.4 age(h) considr photo ex ex &
Chronicity: H – 40 ; if < 0.3 = chronic + 2000 (2L) pCO2 35-45 = 40 photo transif foto
pCO2 0.3-0.7 = ac/chr FiO2 = CA (0.2) + 02 (1) x 100 HCO3 22-26 = 24 foto
> 0.8 = acute TFR O2 80-100 fails
CA = 100 – FiO2 x TFR <24
Oxygenation: 79 Metabolic Acidosis: 25-48 >12 >15 >20 >25
80-100 adequate pCO2 = 1.5 (HCO3) + 8.4  2 49-72 >15 >18 >25 >30
60-80 mild hypoxemia O2 = FR – CA Metabolic Alkalosis: >72 >17 >20 >25 >25
50-60 moderate ET Size: > 2 yo = age(yrs) + 16 0.6-0.7mmHg inc pCO2 q 1meq/L inc
< 50 severe 4 HCO3 LBW
HR RR Respiratory Acidosis: BW phototx exchange
2-12 mo = <160 < 2 mo = up to 60 Acute: 1meq/L inc HCO3 q 10mmHg inc <1500 5-8 13-16
1-2 yo = <120 2mo-2yr = 50 pCO2 1500-1999 8-12 16-18
2-8 yo = <110 1-5 yo = 40 Chron: 3-3.5meq inc HCO3 q 10mmHg 2000-2499 11-14 18-20
inc pCO2
IE: 60/RR - IT Respiratory Alkalosis:
IT Ac: 2-2.5meq dec HCO3 q 10mmHg dec KRAMER'S CLASSIFICATION:
pCO2 Zone Jaundice Est. Levels
PEFR Chr: 4-5meq dec HCO3 q 10mmHg dec I Head/neck 6-8 mg/dl
Ht= x – 100 x 5 + 170 (F)/175 (M) pCO2 II Upper trunk 9-12
III Lower trunk 12-14
% PEFR = actual x 100 def: 0.3 x ABE x wt to thigh
expected IV Arms/Legs/ 15-18
Elbows/Knees
V Hands/Feet > 18

JAUNDICE
VITAL SIGNS INTUBATION/EXTUBATION Initial Vent settings in neonate
Clinical Jaundice INTUBATION
manifestation of color starting I. HEART RATE ET SIZE
at serum bilirubin levels 5-7 mg% <2 mo 140-160 > 2yo: age (yrs) + 16 Settings low moderate high
-------------------------------------
2-12 mo 120-140 PIP <18 18-24 >24
4
Criteria to rule out physiologic jaundice: 1-2 yo 100-120 PEEP <4 5-6 >7
PT: 2 or 2.5
1. Clinical jaundice in the 1st 24 hrs of 2-8 yo 90-110 I Time 0.4 0.4-0.8 >0.8
FT: 3 or 3.5
life. II. RR Rate <20 20-40 >40
2. Increase in total serum bilirubin at <2 mo up to 60 Flow <8 8-10 >10
ET LENGTH
> 5 mg/dL/day (85 umol/L). 2mo-1yr 50 MAP <8 8-12 >12
age/2 + 12
3. Total serum bilirubin > 12 mg/dL in 1y-5y 40
kg cm
full term, and > 15 mg/dL in III. BP
1 7
preterm. syst
2 8
4. Direct bilirubin > 1.5-2 mg/dL upper :yrs x 2 + 90
3 9
(26-34 umol/L). lower: yrs x 2 + 70
EXTUBATION CRITERIA
5. Jaundice lasting for more than 1
FiO2 < 50
week for term, 2 weeks for diast
P/F
preterm. 30 mm Hg lower
no electrolyte imbalance
control of infection
good muscle mass

racemic epi (0.3 mL + 4.7 PNSS)


2.5 mL x 3 d (q4-6)
Dexamethasone 6 hrs prior
then 24 hrs
CARI MALCOLM HOLIDAY STAGES OF DHF
st STAGES OF DHF
(1/4 1 hr; ¾ 7 hrs) 1. Febrile
1. Febrile
2mo-2 yo: 2. Afebrile
2. Afebrile
Mild Pneumonia: Mild Moderate Severe 3. Convalescent
3. Convalescent
send home, TMP-SMX, < 2 yo 50 100 150
Tx fever, ff-up in 2-4 days > 2 yo 30 60 90 GRADING OF DHF
GRADING OF DHF
1. Fever + non-specific ssx; (+)
1. Fever + non-specific ssx; (+)
Severe Pneumonia: Hydrite 1 tab in 100cc water = 8h tourniquet test
tourniquet test
Admit, give IV/IM Benzyl PCN, Glucost 1 sachet in 100cc water = 8h 2. Gr. 1 + spontaneous bleeding
2. Gr. 1 + spontaneous bleeding
Tx fever, tx wheezing, Oresol 1 sachet in 1L water = 24h 3. Gr.2 + manifestations of circulatory
3. Gr.2 + manifestations of circulatory
supportive care, reassess daily Glucolyte 1 sachet in 200cc water failure: rapid, weak pulse; narrow
failure: rapid, weak pulse; narrow
pulse pressure; HPOT; cold, clammy
pulse pressure; HPOT; cold, clammy
Very Severe Pneumonia: extremities
extremities
Admit, give O2, Chloramphenicol, 4. Profound Shock with undetectable BP
4. Profound Shock with undetectable BP
tx fever and wheezing, & pulse
& pulse
reassess BID (q 15min if possible) FLUIDS AND ELECTROLYTES
Days 1-5: petecchiae, fever
Days 1-5: petecchiae, fever
< 2 mos: 1. Hypotonic: D5W; D5NM; D5 0.3NaCl; Days 5-7: bleeding
Days 5-7: bleeding
Severe Pneumonia: D5 IMB; Isolyte; D5 Maintresol > Day 6 : shock
> Day 6 : shock
Hospitalize, keep warm, 2. Isotonic: D5LR; D5 NSS; PLR; PNSS
st
give 1 dose antibiotic Benzyl PCN/ 3. Hypertonic: D50W; D10W CLASSICAL DENGUE FEVER
CLASSICAL DENGUE FEVER
Garamycin/Gentamycin 1. Thrombocytopenia not < 100T
1. Thrombocytopenia not < 100T
2. Hemoconcentration not > 20% of
2. Hemoconcentration not > 20% of
baseline
baseline

PULMONARY VOLUMES BLOOD TRANSFUSION ACTUAL RETIC COUNT (ARC) GLASGOW COMA SCALE

1. Total Volume (TV) = 500 mL FWB 20 cc/k (max) Actual Hct x reticulocyte ct MOTOR
= volume inspired or expired with Desired Hct None 1
each normal breath Vol = desired – actual Hb x 6 x Wt Extension 2
2. Insp. Reserve Volume (IRV) = 3.0 L = desired – actual Hct x Wt RETICULOCYTE INDEX = Arc / 2 Flexion 3
= volume that can be inspired over = Hct / ret ct x 2 Withdraws to pain 4
and above the TV rate = vol x 12 gtts/mL = gtts/min Localizes pain 5
3. Exp. Reserve Volume (ERV) = 1.1L 60 min x 4h > 2 = hemolysis Obeys command 6
4. Residual Volume (RV) = 1.2 L < 2 = BM suppression
= volume that remains in the lungs PRBC 10-15 cc/k VERBAL
after maximal expiration 15 cc/K in neonates None 1
5. Dead Space = 150 mL Vol = desired – actual Hb x 2 x Wt DOUBLE VOLUME EXCHANGE Incomprehensible 2
a. Anatomical: volume of the = desired – actual Hct x Wt TRANSFUSION Inappropriate 3
conducting airways Desired Hct = volume/wt + Actual Hct Confused 4
b. Physiological functional = KBW x estim body vol x 2 Oriented 5
measurement; volume of the lungs Sedimented RBC 15 cc/k
that does not eliminate CO2 PARTIAL EXCHANGE TRANSFUSION EYE OPENING
(usually greater in lung diseases Platelet Conc: 1 U / 6 KBW None 1
with V/Q inequalities) 1U = 30-50 cc (raises platelet ct by 10T) = KBW x estim vol x Hct A-D To PAIN 2
Actual Hct To COMMAND 3
FFP = Fluid rate (5-20 cc/k/h in 4h) Spontaneous 4
1 u = increases Hgb by 2; Hct by 3
Score: < 7 = poor prognosis
IV FLUIDS IVF OF CHOICE ELECTROLYTES APGAR
ACTIVITY (muscle tone)
Na K Cl HCO3 Ca PO4 LBM PLR Na = 135-145 meq (RV= 136 meq) 0 no activity
IMB 25 20 22 23 3 3 Vomiting D5 NSS K = 4-5.6 meq (RV= 4 meq) 1 some flexion
NM 40 13 40 16 3 3 Maintenance D5 NM Ca = 8-10 meq 2 very active
NSS 154 154 BA D5 0.3% NaCl Cl = 98-106 meq PULSE (HR)
LR 130 4 109 28 3 3 Fever & Sweating D5 0.3% NaCl; 0 none
NMR 40 30 Drowning D5W Deficit = (desired-actual) x Wt x 0.6 1 < 100 beats/mi
IsolyteM 40 35 40 Ascitis D5W; D10W 2 > 100 beats/min
IsolyteP 25 20 20 CHF D5 NSS Adult = desired-actual x 350 GRIMACE
PLP48 25 20 22 HPN D5W/D5LR(BP) 3 0 no response
0.3% 51 51 CHF (NPO) D5 NSS Maintenance: Na = 3 meq/kg 1 grimace
0.6% 102 102 2o to HPN D5W K = 2 meq/kg 2 good cry
0.45 77 77 Heat Stroke D5 NSS Na/K deficit is given in 3 days APPEARANCE (color)
0.9% 154 154 Burns PLR Na/K delivery = 0.1-0.4 meq/kg 0 blue
ORS 90 20 80 30 (20 gluc) Azotemia D5W Full incorporation = 40 meq/L 1 pink, bluish extremities
P-lyte90 90 20 80 Inc BUN D10W 2 pink all over
P-lyte Pl 45 20 35 Bleeding D5 LR RESPIRATION
UTI D5 NSS 0 none
Na = 1 meq = 23 mg Profuse Bleeding D5 LR 1 slow, irregular
K = 1 meq = 39.1 mg Dengue Fever D5 0.3% NaCl 2 regular
DM PNSS
2-3 severely depressed
4-6 moderately depressed
7-10 vigorous

IBW
MOTOR GRADING COMPOSITION OF BODY FLUIDS DEVELOPMENTAL MILESTONES
2-12 mo = age in mo x 10
= wt in lbs 0 no movement Na K Cl HCO3 1mo regards
< 6 mo = age in mo x 600 + BW 1 flicker of contraction with no Gastric 50 10-15 150 0 2 smile
= wt in gms associated Panc 140 5 50-100 100 3 turns head
6-12 mo = age in mo x 500 + BW movement at a joint Bile 130 5 100 40 4 holds head
= wt in gms 2 movement present but can’t Ileosto 130 15-20 120 25-30 5 rolls over
< 1 yo = Age (mo) + 9 sustain against gravity Diarrh 50 35 40 50 6 transfers objects
2 3 movement against gravity Sweat 50 5 55 0 7 sits briefly
> 2 yo = age in yrs x 2 + 8 but not with resistance Blood 140 4-5 100 25 8 creeps
= wt in kg 4 movement against some Urine 0-100 20-100 70-100 0 9 pulls up
= age in yrs x 5 + 17 resistance 10 cruises
= wt in lbs 5 movement against full resistance Osm = 2 (Na meq/L + K meq/L) + 11 walks with support
Urine mg/dL – glucose mg/dL 12 stands / walks alone
2.8 18
4-5 = 2 x BW
1 yo = 3 x BW
2 yo = 4 xBW
3 yo = 5 x BW
5 yo = 6 x BW
7 yo = 7 x BW
10 yo = 10 x BW
BCE CALORIC REQUIREMENTS K infusion rate = IV rate x amt of K (mEq)
< 1 mo 110-140 cal/k/day Vol of IVF x wt Normal values:
NB 45-50 cal/kg 1-11 mos 110-115 Normal KIR: 0.1 – 0.3
3-10kg 60-80 1-2 yrs 100-110 Vit K = 0.3 mg/kg for IV antibiotics >7 D Crea (NB): 0.3-1.0
10-15 45-65 3-6 yrs 90-100 pH (premature 48H): 7.35-7.5
15-25 40-45 7-9 yrs 80-90 Ca gluconate - 1 cc/kg/shift (Birth term): 7.11-7.36
25-35 35-40 10-12 yrs 70-80 (5-10’)
35-60 30-35 13-15 yrs 55-65 Ca deficit - 53-75 mEq/k/day (30’)
> 60 25-30 16-19 yrs 45-50 Ca requirement - 27-32 mEq/day (>1 H) 7.26-7.49
(1 day) 7.29-7.45
MF = BCE x Wt x 1.5 = cc/hr PROTEINS RDA Wt x dose (thereafter) 7.35-7.45
24 or ugtt/min 0-5 mos 2.5 g/kg/day 9.8 in 24H pCO2 (NB): 27-40
6-11 mos 2.5-3.0 BUN (NB): 3-12
o
Fever = +12% for every C 1-6 yo 2.0-2.5 Eg. 75 mEq x 3 kg in 24 H Na (NB): 134-146
o
rise > 37.5 C 7-12 yo 1.5-2.0 In q shift = 75 mEq x 3 kg = 75 mEq K (<2 mos): 3.0-7.0
Hyperventilation/dyspnea = + 25% 13-15 yo 1.5 3 shifts (2-12 mos): 3.5-6.0
Bronchial asthma = + 50% 16-19 yo 1.0-1.5 = 75 mEq = 8.3 cc = 72 mEq
Bililight therapy = + 20% 9 (1 cc = 9 mEq)
Milk Formula CHON
Similac 20 cal 1.5/100 Ideal tracheal aspirate: EC <25
NAN 20 1.5/100 PMN’s >10
S-26 20 2.25/100
Pre-NAN 21 2/100 Max steroids for NS : 2 mkD or 60
BM 22 1.1/100 Mkm ≈ 4-6 wks
Enfalac 21 2.25/100

ALL HIGH RISK PROTOCOL Anaphylaxis ANTHROPOMETRY 2. Length


1. Body Weight A. Ave.
PHASE epinephrine. A. Ideal Body Weight Nelson's:
induction 1:1000 At birth 3000 gms Birth Length: 50 cm (20 in)
consolidation 0.01 mkd max of .5 ml IM < 6 mo (g) age in mo x 600 + BW 1yo: 75 cm
maintenance 6-12 mo (g) age in mo x 500 + BW 2-12 yo: yr x 6 + 77
diphenhydramine Nelson's: Height in cm: age inyrs x5 + 80
Vincristine 15 mg/m2 on D0,7,14,21 1-2 mkd IM/IV up to 50 mg q 4-6 3-12 mos (age in mo + 9)/2 Height in in: age (yrs) x 2 + 32
Doxorubicin 25 mg/m2 on D0,7,14,21 1-6 yr (kg) age in yr x 2 + 8
Prednisone 40 mg/m2 on D21-25- Ranitidine 7-12 (kg) (age in y x 7- 5) / 2 3. Head Circumference
L aspariginase 6mg/m2 for 9 doses 1-2 mkD up to 50 mg IV q 6H (Del mundo)
(3 doses per week; mwf/mtw) B. Expected Body Weight (up to 1 mo) At birth 35 cm
Hydrocortisone Term EBW=(age in days-10) < 4 mo 1/2 in/mo (1.3 cm/mo)
5-10 mkd up to 100-500 mg IV q 4-6H x 20 + BW 5-12 mo 1/4 in/mo (0.6 cm/mo)
Preterm EBW=(age in days-14) 1-2 yr 1 in/ yr (2.5 cm/yr)
x 15 + BW 3-5 yr 1/2 in/ yr (1.3 cm/yr)
Where: 10=time to recover over 5-20 yrs 1/2 in/5 yrs (1.3 cm/5yr)
physiologic wt loss (Nelsons))
20=g/day gained 0-3 mo 2 cm/mo
C. Estim wt 3-6 mo 1 cm/mo
4-5mo 2 x BW 5 yo 6 x BW 6-12 m 0.5 cm/mo
1 yo 3 x BW 7 yo 7 x BW 1-3 y 0.25 cm/mo
2 yo 4 x BW 10 yo 10 x BW 4-6 y 1 cm/yr
3 yo 5 x BW
ASTHMA CLASSIFICATION SILVERMAN'S SCORE CHF CLASSIFICATION CONVULSION SCORING
BASED ON SEVERITY 0 1 2
Flaring - min marked *Anatomic factor 0 1 2
intrmtnt persistent Lower chest I acquired occurence none upon spont
mild mod severe Retractions - visible marked II congenital stimulation
Upper chest duration fleeting 10-60s >1min
day sx <1/w >1/w daily daily Retractions - synch in- seesaw *Physiologic (disturbance in) severity mild mod severe
night sx «2/mo >2/mo >1/w >1/w drawing A heart rhythm and conduction twitch clonus
PEFR exp »80 »80 60-79 <60 Xyphoid B myocardial contraction frequency >60mi 60s- >10mi
PEFR var <20 20-30 >30 >30 retractions - visible marked C clinical syndrome (HPN,DM) apart 10 mi
FEV1 »80 »80 60-79 <60 Grunting - steth ears ventilation adeq impair impair
(audible) *Functional cyanosis
ATHMA SCORING I asymptomatic
WOOD'S SCORE 3-4 give 02 II symptomatic w >ordinary act
0 1 2 »7 intubate III symptomatic w minimal activity
p02 or 50-100 «70 in «70 in IV symptomatic at rest
cyanosis rm air 40fio2 Personal best Predictive Value of PEF
Breath snds N unequal absent females: ht(cm) - 100 x 5 + 175 *Therapeutics
Acc muscles N mod max males:ht(cm) - 100 x 5 + 170 A no restriction of act
Exp wheeze N mod extrem B restriction of severe act
Cerebal fxn N depresd/coma agitated actual PEF >80%, normal C restriction of moderate act
D sharp restriction of ordinary act]
1-3 mild asthma attack E complete rest in a chair or bed
4-6 moderate, bedside
7 up severe, intubate

MILK CPAP GUIDELINES Parameters To Be Met B4 Weaning CREATININE CLEARANCE


Abbot,wyeth = 1:2 MJ & Nestle = 1:1 1. Improvement in CXR I. based on height
1. Initially CPAP is set @ 6cm water. If 2. AABG showing PO2 >/= 50 mmHg * 0.33 = preterm,lbw,<1yo
MILK CAL CHON g FAT CHO there is no inc in PO2 in 15 min 3. Blood PH >/= 7.3 0.45=term, infant, <1yo
alfare 72/dL 2.5 3.6 7.8 pressure must be increased in 2cm 4. PCO2 </= 55 mmHg 0.55=children, adolescent fem
bm(t) 699/L 9.09 41.96 72.7 increments to a maximum of 5. Hgb 12-15g% or Hct 36-45 0.7 =adolescent male
75/dl 1.1 4.5 20/oz 10cm. (If by ETT) or by 12cm (in * x ht (cm)
bm (pt) 671/L 14.09 38.93 66.4 other method). Weaning from CPAP -------------------
bonna 22/oz 1.1/dl 2. If there is an increase in PaO2, 1. Decrease FiO2 by 3-5% every time serum crea (mg/dl)
caro syr 120/oz 31 reduce pressure. PaO2 > 70 II. adult
corn oil 813/dL 82 3. If 10-12cm water pressure is 2. With FiO2 of 40%, reduce pressure * male=72
enfalac 67.6/dL 2 3.5 7.4 attained and if PaO2 reamins by increments of 2 cm water every female=85
21/oz 2.25/dl under50, FiO2 must be increased 2-4H until pressure of 2-3cm 140-age x wt
gain 22/oz 2.8g/dL by 5-10% increments. is achieved. -----------------
lactum 21.4/oz 3.42g/dL 4. CPAP failure is evident if PaO2 3. transfer ptient to oxygen hood * x crea (mg/dl)
nan1 67/dL 1.2 3.6 7.5 remains less than 50 in 100% FiO2 with FiO2 of 15-50% VALUES
20/oz 1.5/dl with 10-12cm water. 80-120 normal
nan ha 67/dL 1.51 50-80 renal impairment
neosure 22/oz *If CPAP fails under non invasive 20-50 renal insufficiency
nutren jr 100/dL 3 3.9 13.3 method, an ETT must be inserted. 5-20 renal failure
prenan 80/dL 2.3 4.2 8.6 *If CPAP fails w/ ETT, mechanical <5 uremia
21/oz 2/dl ventilation is indicated.
promil 81/dL 2.4 4.1 8.9 GFR=125 ml/min (75-150)
s26 20/oz 2.25/dl 24 urinary crea: M=15-20 ug/k
s26lbw 100/ 2.4/dL F=10-15
125ml
24/oz
CSF Normal Values ELECTROLYTE COMPUTATION ET Tube Sizes and Distances MODIFIED GLASGOW SCORE
I. POTASSIUM According to Infant Weight FOR INFANTS
OPENING P normal =4-5.6 meq (4)
Newborn 80-110 mm H2O N K deliverance = 0.1 - 0.4 meq/kg MOTOR
Infant <200 mm H2O Weight (gms) l.D. (mm) Depth (cm) 6 spontaneous
GLUCOSE Deficit = (KD-KA) x wt x 0.6 500-1000 2.5 N 7.0 5 withdraws to touch
Premature 24-63 mg/dl Maintenance K= 2 x wt 1000-1400 3.0 7.5 4 withdraws to pain
(csf-bld ratio 55-105%) Total K def = deficit + maintenance 1400-1900 3.0 8.0 3 abnormal flexion
Term 44-128 mg/dl Full incorporation: 40meq/L or 1900-2200 3.5 8.5 2 abnormal extension
(csf-bld ratio 44-158%) 20meq/500cc 2200-2600 3.5 9.0 1 none
PROTEIN K INFUSION RATE 2600-3000 3.5 9.5
Premature 65-150 mg/dl K delivery = ivf rate x K in ivf / vol/ wt 3000-3400 3.5 10.0 VERBAL
Term 20-170 mg/dl normal=0.2-0.4meq/kg 3400-3700 3.5 10.5 5 coos, babbles
II.SODIUM 3700-4100 4.0 11.0 4 irritable, cries
WBC ct maintenance Na=3 x wt 4100-4500 4.0 11.5 3 cries to pain
Premature 0-25 /cumm maximum target/day=10 meq >4500 4.0 12.0 2 moans to pain
(57 % PMNs) Na = 1 mEq = 2.3 mg/dl 1 none
Term 0-22 /cumm K = 1 mEq = 3.91 mg/dl
(61% PMNs) NaHC03= gr x=650 mg=7.7 meq EYE
gr v=325 4 spontaneous
III. CALCIUM normal = 8-10 meq 3 to speech
IV. CHLORIDE normal = 98-106 meq 2 to pain
V. CO2 normal = 15 meq 1 none

DOUBLE VOLUME EXCHANGE EFW GROWTH GROWTH AND DEVELOPMENT


TRANSFUSION I. WT GAIN
station age wt gain length hc 1. Fontanelle Closure
= KBW x EST. Blood vol. x 2 fundic ht (in) - 13 x 155 - (g/day) (cm/mo) cm/mo Anterior : 12-18 mos
12 0 0-3 mo 30 3.5 2 Posterior : 3-4 mos
materials: 11 + 3-6 mo 20 2 1
1. NGT fr. 5 #1 (umbilical cath.) 6-9 mo 15 1.5 0.5 2. Reflexes of Neonates
2. Three way stop cock normal wt for term: 2500-3800 g 9-12mo 12 1.2 0.5 appears disappears
3. FWB 1-3y 8 1 0.25 Moro Birth 8 mos
4. suture Naloxone 4-6y 6 3/y 1/y Stepping Birth 6 wks
5. 50cc syringe Narcan cc=0.1 x efw Placing Birth 6 wks
6. Ca gluconate ----------------- II. Nails 1cm/3mo Sucking & Birth 4 mos,awake
7. HGT strip 0.4 III. Hair 1cm/mo Rooting 7 mos, sleep
given to bb whose mothers were IV. Liver span Palmar Grasp Birth 6 mos
given Demerol with in 4 hrs PTD 1 w : 4.5 5 cm Plantar Grasp Birth 10 mos
12 yo : M 7-8 cm F 6-6.5 Adductor Birth 7 mos
LBW 2000-2499 >12 yo: M: 0.032 x wt(lbs) + 0.18 Spread of knee jerk
VLBW 1500-1999 x ht (in) - 7.86 Tonic Neck 2 mos 6 mos
ELBW 1000-1499 F: 0.027 x wt + 0.22 x ht - 10.75 Neck Righting 4-6 mos 24 mos
V. Gallbladder Landau 3 mos 24 mos
length infants: 1.5-5.5 cm Parachute 9 mos Persists
adolesc: 4-8 cm
width neonates: 0.8 cm
all ages : 0.5-2.5