Pocket Pedia

8/18/2019 Pocket Pedia

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WEIGHT KILOGRAMS POUNDS

AT BIRTH 3.25 7

3-12 MOS + 92

Age (mos) +

11

1-6 YRS Age (yrs) X 2 + 8 Age ( yrs) X 5+ 17

7-12 YRS 7 − 52

Age ( yrs ) X 7

+ 5

HEIGHT centimeter Inches

AT BIRTH 50 20

AT I YR 75 30

2 -12 YR Age ( yr) X 6 +77 Age (yr) X 2.5+ 30

BODY SURFACE AREA :

()3600

APGAR

Sign 2 1 0

Muscle tone(Acticity)

active Someflex./ext

limp

Pulse >100


2/15

Aztreonam(Azactam)

NB2kg: 90mg/k/d q8h IV/IM

(1st week)120mg/k/d q

6h (1-4wk)IN,CH: 90-120 mg/k/dq 6-8hSevere or lifethreatening infxn:2 gms IV q 6-8 h

500 mg,1 g vial

Cloxacillin(Orbenin,Prostaphlin

A)

IN,CH: 50-100 mg/kg/dq6-8 po

A: 2-4g/d q 6 po

250, 500mg cap125mg/5ml susp250mg/5 ml susp250 and 500 mgvial

Oxacillin NB1200g: 50-75 mkd q8-12

(up to 1week)

100-150mkd q6-8

(1-4wks)

IM/IV over15-30

minIN,CH: 100-200 mkd q6 IM/IV

(over 30 mins)50-100mg/kg/day q6 IV

A: 2-12 g/d q4-6 IM/IV(over 30mins)

250mg vial500 mg vial

Nafcillin(Vigopen)

NB: 40mg/k/d q12 IV(up to 1 wk)

60-80mg/k/d q 6-8h (1-4wks)IN,CH: 100-200 mg/k/dq 4-6h IV

250mg/5ml susp250 mg cap500 mg and1 g vial

Pen V(phenoxymethyl-penicillin)

50,000-100,000U/kg/day q6high dose: 150,000-200,000 U/kg/day q6PO(Megapan,Pantacillin,Sumapen, medoxypen)

125mg/5ml(200,000u/5ml)250mg/5ml(400,000u/5ml)500mg cap(800,000 u)

AqueousPen G

Benzylpenicillin

50,000-100,000U/kg/day q6meningitic dose:200,000-400,000U/kg/day q6 IV

1,000,000 U/vial5,000,000 U/vial

PENICILLIN G (PENADUR) = Wt x 100 /600

Benzathine

Crystalline

Procaine

50,000 u/kg singledose IM600,000-1.2 M u IM q3-4 wks(Rheumatic Fever

prophylaxis)

NB: 50,000-100,000u/kg q 6

IV/IMIN,CH: 100,000-250,000 u/kg q

4-6 IM/IV

25,000-50,000ukd, IMq 12-24Meningitic: 200,000-400,000Skin infxn:150,000u/k/d x 10 days

1.2 M & 2.4 M uvial

1M and 5M u vial

CEPHALOSPHORINS

1st GENERATION

Cephalexinmonohydrate

TD: 30-50 mg/k/d q6-8OM: 75-100 mg/k/d

(keflex)100mg/ml drops125mg/5mlsusp,250mg/5ml susp250, 500 mg 1 gcap250, 500 mgpulvule

Cefalothin Na 80-160 mg/k/d q 6h

life threatening: up to2g/k/d q4

1g/vial

(Keflin)

Cefazolin NB: 40mg/k/d q 12 (1stwk)

40-60mg/k/d q8-12 (1-4 wks) IM/IV over 15-30minIN,CH: 50-100mg/k/d q8IM/IV

(Stancef)500mg &1 g vials

2nd GENERATION

Cefaclor(ceclor)

IN,CH: 20-40mg/kg/daypo q8

A: 750mg-1.5g q8

250, 500 mg cap125mg/5 mlsusp250mg/5 mlsusp

Cefuroxime 100-150 mg/kg/d q8 IM/IV10-15 mkday q12 oral

250mg/kg/d q 6 IV (forbacterial meningitis)OM: 40mg/k/d q 12>5 yrs: 30 mkd q 12>5 yrs: 40 mkd q 12

A: 250mg q 12

Zinacef:250mg, 750mg,

1.5g vial;125mg/ml susp125mg, 250mg,500mg tabZinnat: 125,250mg sachetsusp., 125mg,250mg, 500mgcoated tab

Cefetamet CH12 yrs: 500 mg po q 12

(globocef)250, 500 mg tab250mg/5ml susp

Cefoperazone CH: 100-150mg/k/d q 6-8IM/IV

A: 2-12g/d IM/IV q 6-8

(cefobis)500 mg, 1 gvials

Cefotaxime IN,CH: 50-100mg/k/d q

12-16h A (gonorrhea): 500mgIM/IV SD

(Claforan)

250mg, 500mg,1 g vial

Cefoxitin 80-160 mg/kg/day IM/IV q4-8

(Mefoxin) 1 gvial

3rd GENERATION

Ceftriaxone(3rd gen)

50-100mg/kg/day q12-24IVTyphoid:75-80mg/kg/dayx

A: 1-4 g/d

(Rocephin)IM: 250mg,500mg, 1 g (inj.w/ lidocaine)IV: 250mg,500mg, 1 g (inj.w/ 1% water)

Ceftazidime(3rd gen)

NB


3/15

MACROLIDES

Azithromycin CH: 10mg/kg/day x 3days or alternatively for5 days w/ a single10mg/kg dose on day 1then 5 mg/kg on D2-5

250mg cap200mg/5mlpowder for oralsuspension

Clarithromycin

CH: 15mg/kg q12 po A: 500-1000 mg q12Severe infxn: 2 tab BIDx 6-14 days

(Klaricid)250mg tab125mg/5mlsusp

Erythromycin IN,CH: 30-50mg/kg/dayq6 po

15-30mg/k/d q6

SIV infusion A: 1-2 g/k/d q6 po1-4gkd q6 IV

Int. antisepsis: 1 g/dosex 3 doses (1pm,2pm,11pm) the day before sx

(Erycin,Macrodin,Ilosone

125mg/5ml;250mg/5ml)100mg/2.5mldrops250mg, 500mgcap200mg/5mlsusp400mg/5mlsusp500 mg vial

Roxithromycin (Rulid,Macrol)

A: 1 tab BID po 15-30min before meals

QUINOLONES

Ciprofloxacin(Ciprobay)

A: 500mg-1.5 g po q12100-200 mg as IV

infusion for 30 min q12Norfolxacin UTI: 200-400 mg BID

GI infxn: 400 mg BIDGonorrhea: 800mg SD

OfloxacinUncom.

UTICompl.

UTI, Pn, OM,sinusitis, skin& soft tissueinfxn

GonococcusNon-

gonococcus

GI infection

100mg BID po x 2-7days200mg BID po x 7-14days

300-600mg as singledose100-200mg BID x 7-14days

200-300mg BID x 5-7days

Inoflox, Qinolon

100, 200mg tab

Chloramphenicol

NB1200g: 25-50mkd q12-24h, IV over 15-30 min(1st week)IN,CH: 50-100 mkd q6po

IM/IV

(pediachlor,chlormycetin,Chloramol,chlorambid)125mg/5mlsusp250mg, 500mgcap1 g vial

Clindamycin NB2g: 15mg/k/d q8 or

20mg/k/d q6IN,CH: 10-40 mg/k/d q6

(dalacin-C)150mg, 300mgcap

150mg/ml amp

Imipenem-Cilastatin

IN,CH>3mos: 15mg/k/dq6

A: 1-2 g IV infusion*Crea clearnce of15ml/min should notreceive unlesshemodialysis isinstituted within 48 hrs

(Tienam)500 mgimipenem500 mgcilastatin, 1amp

Co-trimoxazole(SMX-TMP)

5-8 mg/k/d q 12 (Bactrim,Septrin,Microbid)40mg+200mg/5

mlTriglobe:

45mg+205mg/5mlBacidal80mg+400mg/5ml160mg+800mgforte tab80+400mgtab/cap160mg+800mgtab

AMINOGLYCOSIDES

Amikacin(Amikin,Pediakin)

NB: 15 mkd q12 (1stwk)15-22.5 mkd q8-12

(1-4 wks) IM/IV (over 1-2h)IN,CH,A: 15 mkd div q8IM/IV (over 30-60 min)LD: 10 mg/k/dose

250mg/ml,(2ml) vial125mg/ml,(2ml) vial50 mg/ml (2ml)vial

Gentamicin(Garamycin,Servigenta,Progara)

NB:


4/15

COLDS PREPARATION:

Phenylpropanolamine(decongestant)

1-3mos: ¼ ml q 84-6mos: ½ ml q 87-12 mos: ¾ ml q 81-2 yr: 1 ml q 82-6 yr: ½ tsp q 87-12 yr: 1 tsp q 8

Disudrin12.5mg/5mlsyr6.25 mg/mldrops

Combined Prep: Rondec, Drixine, Sudafed, Dimetapp,Decolsin, Triaminic, Tridecon

Brompheneraminemaleate,phenylephrine,phenylpropanolamine

1-3 mos: 0.25 cc4-6 mos: 0.5 cc7mos-2 yrs: 1 cc3-12 yrs: 1 tsp TID

DimetappPer 5 ml syrupPer infant drop

Iron SupplementDose: 3-5 mg/kg/day (maintenance)

6 mg/kg/day ( therapeutic dose)preparation: drops 15 mg/ml

syrup 30 mg/5 ml

Immuzincdose: 1-2 mg/kg/dayprep: 20 mg /5 ml syrup10 mg/ml drops

Nifuroxazide (ercefuryl)< 6 monts 1 tsp BID> 6 months 1 tsp TID

Calcium Gluconate Dose: 200-300 Ex. WT x dose x prep1.4 kg x 200 mg/ml = 290 mg/ml x 100mg /ml= 2.9 ml

NaloxoneDose: 0.1 mg/kg/dose IV/IM/SC

Theophyllineprep: 80 mg/ml

26.7 mg/mldose: 2.5 mg/kg/dose q12

ANALGESICS DOSE PREPARATION Aspirin

ThrombolyticRHD activityKawasaki

65-130 mg/kg/d q 4-6h3-5 mg/k/day75-100mg/k/day80-100 mkd q 6h x2wksthen 3-5 mg/kg x 6-8

wks

80 mg, 325 mgtab

Diclofenac CH: 50 mg tab BIDduring or after meals

A: 75-100 mg daily

25, 50 mg tab100 mg tab (SR)25mg/ml (3ml)amp

Mefenamic Acid

6.5 mg/kg/dose q 6 h 50 mg/5ml susp(ponstan,tynostan)250, 500 mgtab/cap

Paracetamol 10-15 mg/kg/dose q4-6 h

150mg/ml (2mlamp)125, 250 mgsusp325, 500 mg tab120, 250/5mlsyrup60mg/0.6 mldrops

BRONCHODILATORS

Aminophylline 3-5 mg/kg/dose or0.6-0.9 mg/k/hrLD: 5-7 mg/k/doseMD: 3-5 mg/k/dose q 6hr + 2 or 3 cc IVF torun for20-30 min

25mg/ml (10ml)amp80mg/15ml syr(nuelin)125, 250 mg tab(nuelin,phenedrine)120mg tab(tedral)

Ipratropium +Fenoterol(Berodual)

7 yrs, A: 2-10gtts (0.1-0.5 ml)3-6x daily ( min

interval: 2 hours)

MDI: 20mcg I +50 mcg F/10ml250mcg I + 500

mcg F/ 20mlinhalant

Salbutamol

Nebulizer

0.1-0.15 mkd po q 6-8or 2.5 ml tsp q 6-8 ( 6mos-3 y/o) or 5 ml q 6-8 hrsrecommended dose:0.1-0.3 mg/k/d

0.01 ml/kg (max 1 ml)in 3ml NSS or 5-10gttin 2ml NSS q6

2mg/5ml syrup(activent,librentin, ventolin)1mg/5ml expector2mg tab2.5mg/2.5ml nebor 5mg/2.5 neb200ug rotacap0.1mg/inhalation(Asmalin)5mg/ml resp soln0.5mg/ml(2ml)amp

Terbutaline

Nebulizer

0.1-0.18-5 mkd po q 8or 0.075 mg/k dose q 6

hr; or 1 mcg SC to rptprn after 20 min oncedaily

0.01 ml/kg (max of 1 mlin 3 ml NSS or 5-10 gttin 2 ml NSS) q 6

0.5mg/ml (1ml)amp

1.5mg/5ml syr(betalin, bricanyl,pulmoxel,terbulin)2.5 mg tab5 mg tab (ER)2.5mg/ml (2ml)neb0.5mg/dturbohaler, 100 d

Ketotifen 6mos-3 yrs: 1 drop BIDor 0.25 ml syr BID>3 yrs: 5 ml syrup BID

(zaldec, Zadilen)1mg cap1mg/5ml syr

Clenbuterol


5/15

Solmux) TID4-7 yrs: 5 ml TID8-12 yrs: 7.5 ml

Solmux:250mg/5 ml500 mg/5mlsuspension

S-CARBOXYMETHYLCISTEINE (LOVISCOL,MUKINYL,VISCODEC)

Loviscol 12 yrs: 7.5 ml BID or½ tab to 1 tab BID poor0.025 mg/k IM

0.5mg/ml syr1mg tab2mg/2ml amp

Diphenhydramine(Benadryl)

3-5 mg/kg/day q 6 po,IM, IV

25mg, 50mg cap12.5mg/5ml syr50mg/ml (1ml)amp

HydroxyzineHCl (Iterax)

10 mg OD or1 mg/k/day BID

0.2 mg/syrup10, 25 mg tabs

Mequitazine(primalan)

½- 2 tabs/day accdgto age

5 mg tab2.5mg/5ml syr

Terfenadine(Teldane)

15-30 mg BID 30mg/5ml syr60mg tab

ANTI-CONVULSANTS

Carbamazepine LD: 10-20 mg/kgMD: 5 mg/kg/day

Tegretol100mg/5ml syr200mg tab

Clonazepam IN,C 10 yrs: 1- 2 mg/k/dMD:


6/15

ANTI-ULCER

Antacid 2-4 tabs chewtab QID1 hr after meals or2-4 tsp QID susp

Chewable tabs250 and 500 mlsusp

Cimetidine (tagamet)

5-7.5mg/kg/dose q 6po/IV or10-20 mg/kg QID

200,400,800 mgtab100mg/ml (2ml)amp100mg/5ml syrup

Ranitidine(Zantac)

2-4 mg/k/dose BID poor1 mg/k/dose TID, IV

75,150, 300 mgtabs150mg/5ml syrup50mg/2ml amp

ANTI-SPASMODIC

Bentyl 2.5-10 ml TID 10 mg tab10mg/5ml syrup

DicycloverineHCl,Simethicon

IN: 0.5-1 ml gtt or ½tsp syr QID/TID1-5 yrs: 2.5-5mlTID/QID6-12 yrs: 5 ml

Relestal: 5 mg/mldrops10mg/5ml syrup

Hyoscine-N-butyl bromide(buscopan)

IN: ¼ amp TID IM, SCor slow IVCH, A: 1-2 tabs 3-5 xdaily

10 mg tab5 mg/5 ml syrup20 mg/ml amp

ANTI-FLATULENT

Dimethyl-polysiloxane

A: 1-2 tab TID po 40 mg tabDisflatyl, Gascon

ANTI-HELMINTICS

AlbendazoleNematodeCapillariasis

Strongyloidiasis

400 mg po200 mg BID x 10days400 mg q day x 3days

Zentel200 mg/5ml syr400 mg tab

Mebendazole(Antiox)

200 mg po BID x 3days or 500 mg poone dose

100, 500 mgtab100 mg/5 mlsusp

Piperazine(Expelin,

Aloxin)

75 mg/kg (max:3.5g/d) q day x 2 days(for ascariasis only)

1.25 mg/5 mlsyr62.5 mg/5 mlsyr

Pyrantel

Pamoate

11 mg/kg/day (max 1

g) x 3 days

Combantrin

250, 500 mgtab125, 250mg/5mlQuatrel:100 mg/5 ml100 mg tab

ANTI-DIARRHEALS

Nifuroxazide( Ercefuryl)

6 mos: 3 tsp daily

A: 1 cap QID

200 mg cap220mg/5mlsyr

Paromomycin +kaolin + pectinBacterialdiarrhea

AmeobiasisDysenteryPre-opHepatic comaTaeniasisGiardiasis

6 doses35 mg/kg x 4 consecdays75mg/kg20-50 mg/kg/day x 5days20-30 mg/kg/day x 5-8days

Humagel150 mg cap50mg/5mlsusp

OPTICAL ANTI-INFECTIVES:

Chloramphenicolsolutionointment

1 gtt 2-4x/day (1 gtt/hr foracute cases) Apply insidesurface of lower lid

0.25%,0.5%, 1% 5ml drops0.1%,0.5%3.5 g tube

Framycetinsolutionointment

1-2 gtts q 1-2h or 1-2 gtts3-4x/day (acute)2-3 application daily or atbedtime

0.5% 2.5mldrops, 0.5%2.5 g tube

Sulfacetamide 1-2gtts into lowerconjunctival sac 2-3h

10% 15%5ml drops

TobramycinSolutionointment

1-2 gtts q4½ in ribbon intoconjunctival sac 2-3x/day

3mg/ml(0.3%),5ml3mg/g

(0.3%) 3.5gtube

AMEOBICIDES

Diloxanidefuroate(furamide,elizol)

20mg/k/day po TIDx 10 days

125mg/5ml

Etofamide(kitnos)

CH: 15-20ml/kg/dayor 2 tsp TID x 3days

A: 5 tabs BID x 3days or 1 forte tabBID

100mg/5ml susp200mg tab500 mg forte

EAR PREPARATIONS:

1. Antiseptics with corticosteroidsPolymyxinB+Neomycin+HAA

Cortisporin 3-4 gtts tid-qid

5mldrops

Fluocinoloneacetonide +polymyxin B +neomycin

Aplosyn,Synalar

3-4 gtts tid-qid

5 mldrops

Triamcinoloneacetonide +neomycin +gramicidine +nystatin

kenacomb 2-3 gtts tid-qid

7.5mldrops

2. Anti-Infectives and Antiseptics

Chloramphenicol Chloromycetin 2-3 gtts bid-qid

(5%)5ml

Polymycin B + glaci

acetic acid

Aerosporin 3-4 gtts tid 10ml

dropsPolymycin B +lidocaine

Lignosporin 3-4 gtts tid 10mldrops

3. Miscellaneous

Antipyrine +Benzocaine +glycerinedehydrated

Auralgan Moisten cottonplug with solutionthen insert intomeatus tid-qid

10ml,15mldrops

Dousatesodium

otosol Fill ear canal witsoln & stay inposition for 4-5min then insert acotton wool plug x2 consecutivenights

(0.5%)10 mldrops


7/15


8/15

mo alone pincer grasp,can make a

crayon mark,releases

voluntarily

words otherthan

mama/dada orproper nouns,

jargoning(runs severalunintelligible

wordstogether with

tone orinflection),one-step

command withgesture

actions,comes when

called,cooperates

with dressing

15mo Creeps upstairs,walks back-

wardsindependen

tly

Scribbles inimitation,builds towerof two blocksin imitation

Uses 4 –6words, followsone-stepcommand

withoutgesture

15 –18 mo:Uses spoonand cup

18mo

Runs,throwsobjects

fromstandingwithoutfalling

Scribblesspontaneous

ly, buildstower of 3

blocks, turns2 –3 pages at

a time

Mature jargoning(includesintelligible

words), 7 –10word

vocabulary,knows 5 body

parts

Copiesparent in

tasks(sweeping,dusting),plays in

company ofother

children

24mo

Walks upand down

stepswithout

help

Imitatesstroke with

pencil, buildstower of 7

blocks, turnspages one at

a time,removesshoes,

pants, etc.

Usespronouns (I,

you, me)inappropriately, follows two-

stepcommands,has a 50 –

wordvocabulary,

uses two-wordsentences

Parallel play

3 yr Canalternatefeet whengoing up

steps,pedalstricycle

Copies acircle,

undressescompletely,

dressespartially,

dries handsif reminded,unbuttons

Usesminimum of

250 words, 3 –word

sentences,uses plurals,

knows allpronouns,

repeats twodigits

Group play,shares toys,takes turns,plays well

with others,knows full

name, age,gender

4 yr Hops,skips,

alternatesfeet going

down steps

Copies asquare,buttonsclothing,

dresses selfcompletely,catches ball

Knows colors,says song orpoem from

memory, asksquestions

Tells ―talltales,‖ playscooperativelywith a groupof children

5 yr Skipsalternatingfeet, jumps

over lowobstacles

Copiestriangle, ties

shoes,spreads with

knife

Prints firstname, askswhat a word

means

Playscompetitive

games,abides by

rules, likes tohelp in

householdtasks

Age Cal per kgProt g/kg

0.5 mos 115 3.5

6-11 mos 110 3.0

1-2 yrs 110 2.5

3-6 yrs 90-100 2.0

7-9 yrs 80-90 1.5

10-12 yrs 70-80 1.5

13-15 yrs 55-65 1.5

16-19 yrs 45-50 1.2

Age Normal respiratory rate

20kg

Ludansmethod

2 kg

mild 50 30

moderate 100 60¼ PLR ¾ D50.9 6-7 hrs

severe 150 901/3 PLR x 1 hr

2/3 D5 0.3 or 0.9 6-7hrs

For every degree rise in temperature add 12% Of maintenance

IVF components (meq/L)

Na K Cl base Mg

D5LRS 130 4 109 28 -

D5 0.3 Nacl 51 - 51 - -D5 0.45 Nacl 75 - 75 - -

D5 0.9 NaCl 154 - 154 - -

D5 mannitol 49 25 19 20 -

D5 NR 140 5 98 50 -

D5 NM 40 13 40 16 -

D5 IMB 25 20 22 23 -

NP 30 20 25 23 -

D5NSS 150 - 150 - -

D5W - - - - -


9/15

WHO treatment plan (CDD)

Plan A

Age in yrs. Give every after BM

10 As much as tolerated

Plan B

Age Weight Ml in 4 hours

6.5 meg/lMgt: glucose 0.5 – 1 g/kg + insulin 0.1-0.2 units/ kgover 30 minutes

Bicarbonate Correction

Total Bicarbonate correction= Wt. x 0.3 x base excess

Calcium GluconatePreparation 10% calcium gluconate= 10 g = 100 mg100 cc ml

maintenance = 150-200 mkdayEx. Wt x desired ( 4.1 x 200 = 820mkday)= 100 = 8.2 ml div into doses

X ml

Blood Transfusion

FWB: 10 cc/kg 4-6 hoursPRBC: 10 cc/kg 4 hoursPlt Conc: 1 unit/7 kg fast dripFFP: 10 – 15 cc/kg 2-4 hrsCryoppt: 1unit/5 kg

How to compute ANC= WBC(% neutrophils + % bands) x 1000

Fluid Balance

TFB=Total fluid intake – total fluid outputTFI – ( TFO + (BSAxIWL))TFI = parenteral (IVF/meds) + oralTFO= IWL (400-700/m2) + urine output+ vomitus/ NGT outputTFR = BSA x IWL + ½ U.O in 24 hours(if with diuretics )If w/o diuretic use BSA x IWL + U.O in 24 hours

Albumin Transfusion

Dose: 0.5 -1 gm/kgPreparation: 20% 10 gm

25 % 12.5 gm

Transfuse 1 vial to run for 2 hrs at 6-7 gtts/min After 1 vial give furosemide (1 mkdose)Give 2

nd vial then furosemide

Mobitor VS q 15 mins while ongoing Infusion

IVIg Computation

# of vials needed = WT. x Dose (2g/kg)preparation(g/ml)

Ex. 12 kg

# of vials needed = 12 kg x 2g/kg2.5 g

= 9.6 vials or 10 vialsInfusion Rate:0.01-0.02 ml/kg/min for the first 30 mins. Via infusion pump ifno adverse reactions noted, may increase to maximum of

0.04 ml/kg/minEx: 12 kg wt

Infusion rate of 0.0112 kg X 0.01 x 3o mins = 4 ml* give for ml to run for 30 mins watchout for nausea, vomiting,chills fever, dyspnea, malaise, hjeadache etc.

2. increase to infusion rate 0f 0.02 x 60 mins12 x 0.02 x 60 = 15 ml to run for 60 min

3. remaining to run for 14 hours

IVIg Preparation Available

10 ml (500mg/vial)20 ml (1000 mg/vial)

50 ml (2500 mg/vial)100 ml (5000 mg/vial)200 ml ( 10000 mg/vial)


10/15

Haesteril 6%

1 inc. erythropoeisis, inc BM activity, hemolysis

< 1 dec. erythropoeisis, BM failure

Hypoglycemia

normal glucose value(mg/dl)

premature 20-60

neonate 30-60

newborn:

1 day 40-60

>1 day 50-90

child 60-100

fasting 70-105

2 hours PP


11/15

Ex. BW = 3 kg3 x 2 ml = 6 ml6 x factor = 6 x 0.11

= 0.66 ccorder: 5.3 cc of present IVF (or D5W) + 0.7 cc of D50-50 tomake D10 as bolus

Croup Scoring

Hypoxic Ischemic Encephalorathy (Sarnat Scoring)

I II III

level of conciusness alert lethargy coma

muscle tone normal orhypertonic

hypotonic failed

myoclonus + + -

seizure - + +

suck reflex active weak absent

moro reflex exagerated inc. -

grasp N or inc exag. -

dolls eye N overactivity dec. 0r -

respi. reg. varies apneicCR N or tachy brady brady

pupils dilatedreactive

anisoreactive

anisononreact.

TABLE 25-3 -- EVALUATION OF CEREBROSPINAL FLUID

WBC Count Mean % PMNs

Preterm 0 –25WBCs/mm

3

57%

Term 0 –22WBCs/mm

3

61%

Child 0 –7WBCs/mm

3

5%

GLUCOSE

Preterm 24 –63 mg/dL 1.3 –3.5 mmol/LTerm 34 –119 mg/dL 1.9 –6.6 mmol/L

Child 40 –80 mg/dL 2.2 –4.4 mmol/L

CSF GLUCOSE/BLOOD GLUCOSE

Preterm 55% –105%

Term 44% –128%

Child 50%

LACTIC ACID DEHYDROGENASE

Normal range 5 –30 U/L (or about10% of serum value)

PROTEIN

Preterm 65 –150mg/dL 0.65 –1.5 g/L

Term 20 –170mg/dL

0.20 –1.7 g/L

Child 5 –40mg/dL

0.05 –0.40 g/L

CSF, cerebrospinal fluid; PMNs, polymorphonuclearlymphocytes; WBC, white blood cell.

Modified from Oski FA: Principles and Practice of Pediatrics,3rd ed. Philadelphia, JB Lippincott, 1999.

TABLE 25-2 -- EVALUATION OF TRANSUDATE vs. EXUDAT(PLEURAL, PERICARDIAL, OR PERITONEAL FLUID)

Measurement* Transudate Exudate

Specific gravity 1.016

Protein (g/dL) 3.0

Fluid : serum ratio 0.5LDH (IU) 200

Fluid : serum ratio(isoenzymes not useful)

0.6

WBCs‡ 1000/mm

RBCs 1 suggpancreatitis.

TABLE 1-2 -- MANAGEMENT OF CIRCULATION

Location* Rate

(per min)Compress

Ventilat

Infants 1 fingerbreadth

below intermammaryline

>100 5:1

Children(8 yr)

Lower half ofstemum

100 15:2

TABLE 17-3 -- PREDICTED ENDOTRACHEAL TUBE SIZE ANEXPECTED BIRTH WEIGHT BY GESTATIONAL AGE

*

GestationalAge (wk)

Weight(g)

ETT Size(mm)

ETT Depth of Inser(cm from upper li

24 700 2.5 7

26 900 2.5 7

28 1100 2.5 –3.0 7

30 1350 3.0 732 1650 3.0 7

34 2100 3.5 8

36 2600 3.5 8

38 3000 3.5 –4.0 9

LABORATORY DIFFERENTIATION OF OLIGURIA Test Prerenal Renal

FENa 3%

BUN/Cr ratio >20 :1 1.015


12/15

TABLE 17-11 -- GUIDELINES FOR USE OF PHOTOTHERAPY IN

PRETERM INFANTS 2500 >15 >20

GUIDELINES FOR USE OF PHOTOTHERAPY IN PRETERMINFANTS 2500 >15 >20

CALCULATION OF EXPECTED COMPENSATORYRESPONSE

Disturbance PrimaryChange

pH ExpectedCompensatory

Response

Acuterespiratoryacidosis

↑ PaCO2 ↓ pH ↑ HCO3- by 1 mEq/L

for each 10 mmHgrise in PaCO2

Acute

respiratoryalkalosis

↓ PaCO2 ↑ pH ↓ HCO3- by 1 –3

mEq/L for each 10mmHg fall in PaCO2

Chronicrespiratoryacidosis

↑ PaCO2 ↓ pH ↑ HCO3- by 4 mEq/L

for each 10 mmHgrise in PaCO2

Chronicrespiratoryalkalosis

↓ PaCO2 ↑ pH ↓ HCO3- by 2 –5

mEq/L for each 10mmHg fall in PaCO2

Metabolicacidosis

↓ HCO3- ↓ pH ↓ PaCO2 by 1 to 1.5

× fall in HCO3-

Metabolicalkalosis

↑ HCO3- ↑ pH ↑ PaCO2 by 0.25 –1

× rise in HCO3-

Lumbar Tap OrdersPlease secure consent Prepare the ff materials:

Sterile gloves size _____Disposable needle q 23/24Sterile Specimen bottles #4Eye sheetSterile gauze/cottonBetadine/Alcohol #1

Secure ___________ for sedationFor HGT prior to LT

Post Lumbar Tap Orders

>Flat on bed for 4 hours>NPO temp for 2 hours then may feed oncefully awake with aspiration precaution>Monitor VS q 15 min x 1 hour, q30 mins x2 hours then q 1 till stable>Send CSF Specimen to the lab as ff:

bottle #1 : GS/CS; AFB#2 : RBC, WBC, diff ct.#3 : protein/sugar#4 phadebact ( test for strep B, H. I influ, strep Pn, Nmeningitides)

Blood transfusion Orders

Secure and transfuse (blood product )to run for hoursproperly 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 asfever, chills, rashes, DOB, 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 0.5- 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. and post BT (depends sa AP)

For exchange transfusion ordersPls. 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%0.7 ml + 0.7 ml sterile water IVpush every 10 exchanges> give furosemide after exchange

Pulse Cyclophosphamide Therapy( for Systemic Lupus Erythematosus)Pre hydration:- D5W 750 ml to run for 1 hour alternate with D5 0.3 Nacl 750 for 2 doses- Ondansetron (zafran) 8 mg/4ml, 4 mg +50 ml D5W to run for - cyclphophamide 1gm (1000 mg) + 100 ml D5W to run for 1 h

Post chemo/ cyclophosphamide hydration- same regulation as pre chemo hydration- ondansetron 4mg + 50 ml D5W for 30mins- Prednisone 20 mg OD after breakfast- TPR q4 and record pls.- I and O q shift- limit sodium intake to 2 g/day- maintain on heplock after 10 hrs. therapy

Materials for Triple Intrathecal (TIT)

> NPO temp. For 4-6 hours> secure consent> prepare the ff. materials:

- sterile gloves size_______- sterile eyesheet- sterile cotton balls- sterile gauze- sterile water 50 ml #1- tuberculin syringe #3- sterile specimen bottle #1- 2.5 cc syringe #1

>sterile needle g 23 or ___


13/15

ACID PHOSPHATASE

(Major sources: prostate and erythrocytes)

Newborn 7.4 –19.4 U/L 7.4 –19.4 U/L

2 –13 yr 6.4 –15.2 U/L 6.4 –15.2 U/L

Adult male 0.5 –11.0 U/L 0.5 –11.0 U/L

Adult female 0.2 –9.5 U/L 0.2 –9.5 U/L

ALANINE AMINOTRANSFERASE (ALT)

(Major sources: liver, skeletal muscle, and myocardium)

Neonate/infant 13 –45U/L

13 –45 U/L

Adult male 10 –40U/L

10 –40 U/L

Adult female 7 –35 U/L 7 –35 U/L

ALDOLASE

(Major sources: skeletal muscle and myocardium)

10 –24 mo 3.4 –11.8 U/L 3.4 –11.8 U/L

2 –16 yr 1.2 –8.8 U/L 1.2 –8.8 U/L

Adult 1.7 –4.9 U/L 1.7 –4.9 U/L

ALKALINE PHOSPHATASE

(Major sources: liver, bone, intestinal mucosa, placenta, andkidney)

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

Adolescentfemales

100 –320 U/L 100 –320 U/L

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 –35.7 μmol/L

AMYLASE

(Major sources: pancreas, salivary glands, 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 :320

Patterns with clinical correlation:

Centromere—CREST

Nucleolar —Scleroderma

Homogeneous—SLE

ANTISTREPTOLYSIN O TITER

(4-fold rise in paired serial specimens is significant)

Preschool 19yr)

7.35 –7.45

90 –110 35 –45 22 –2

BILIRUBIN (TOTAL)

Cord

Preterm


14/15

CREATININE (SERUM)

Cord 0.6 –1.2 mg/dL 53 –106 μmol/L

Newborn 0.3 –1.0 mg/dL 27 –88 μmol/L

Infant 0.2 –0.4 mg/dL 18 –35 μmol/L

Child 0.3 –0.7 mg/dL 27 –62 μmol/L Adolescent 0.5 –1.0 mg/dL 44 –88 μmol/L

Man 0.7 –1.3 mg/dL 62 –115 μmol/L

Woman 0.6 –1.1 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

FERRITIN

Newborn 25 –200 ng/mL 20 –200 ng/mL

1 mo 200 –600 ng/mL 200 –600 ng/mL

2 –5 mo 50 –200 ng/mL 50 –200 ng/mL

6 mo –15 yr 7 –140 ng/mL 7 –140 ng/mL Adult male 20 –250 ng/mL 20 –250 ng/mL

Adult female 10 –120 ng/mL 10 –120 ng/mL

FOLATE (SERUM)

Newborn 5 –65 ng/mL 11 –147 nmol/L

Infant 15 –55 ng/mL 34 –125 nmol/L

2 –16 yr 5 –21 ng/mL 11 –48 nmol/L

>16 yr 3 –20 ng/mL 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/L3 –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

GLUCOSE (SERUM)

Preterm 20 –60 mg/dL 1.1 –3.3 mmol/L

Newborn, 1 day 50 –80 mg/dL 2.8 –4.5 mmol/L

Child 60 –100 mg/dL 3.3 –5.6 mmol/L

>16 yr 74 –106 mg/dL 4.1 –5.9 mmol/L

HEMOGLOBIN A1 C 5.0 –7.5% total Hgb

Adult 12 yr 2.7 –4.5 mg/dL 0.87 –1.45 mmol/L

POTASSIUM

Newborn 3.7 –5.9 mEq/L 3.7 –5.9 mmol/L

Infant 4.1 –5.3 mEq/L 4.1 –5.3 mmol/L

Child 3.4 –4.7 mEq/L 3.4 –4.7 mmol/L

Adult 3.5 –5.1 mEq/L 3.5 –5.1 mmol/L

PREALBUMIN

Newborn 7 –39 mg/dL

1 –6 mo 8 –34 mg/dL

6 mo –4 yr 2 –36 mg/dL

4 –6 yr 12 –30mg/dL

6 –19 yr 12 –42

mg/dL


15/15

ConventionalUnits

Sl Units

PYRUVATE 0.3 –0.9 mg/dL 0.03 –0.10 mmol/L

RHEUMATOIDFACTOR

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