pediatric board review and stat fact
wide complex tacky in child >0.00 sec is V tall
.5 to 1 j/kg then 2 j/kg, consider amiodarone 5mg/kg iv over 20 min, procaniamide 15mg/kg over 30 or lidocaien 1mg/kg bolus
adenosine dose
0.1 mg/kg max 6 mg for svt
Cardioversion joules
0.5 to 1 jouls for sat or vt, then later 2 jouls 2 jouls then 5 cycles cpr, later 4 jouls/kg add epi, amiodaron, possibly lidocaine
pyloric stenosis
1 in 250, 3 to 5 week of life, often male, occasional non billious developes into classic projectile in an eager feeder. lab for cl, k us for wall. nl is less than 2 mm in pyloric stenosis is >3 and length is 15-19
lidocaine dose
1 mg/kg
CPR rate RBC bolus Epi dose
30:2 compression/vent 2 person 15:1 once airway in 8-10/minute RBC 10ml/kg epi 0.01 of 1:10,000 IV?IO
intussusception
90% idiopathic 10% have a lead point kids <2 are idiopathic viral illness prior? peak6 to 11 months classic triad of ruq pain, vomiting, and bloodyh stool seen in 20--40 big mental status changes, big irritaiton/irritablitiy x ray might help ultrasound for donut sign ghen give enema. 90% retuce and 10% go to OR
Bradycardia in kids
<60 is car at 100/min epi is 0.01 of 1:10000 IV or IO every 3 minutes atropine 0.02 mg/kg iv consider dopamine 5-20 micrograms/kg/min
differential and pain of childhood
Appy, Gastro, pancreatitis, GB dz. UTI, Ulcers HUS HSP, IBD stone, adenitis
Tacycardia with poor perfusion
HR>220 in infant or 180 in child SVT? Vagal? Adenosine? Cardioverison Wide complex is V tack cardiovert ASAP 0.5 to 1 jould/kg then 2J/KG
atropine dose
atropine 0.2 mg/kg minimum 0.1 maximum 0.5 given only for symptomatic bradycardia or salivation not given for resuscitation
abd pain in adolecence
ectopic, appi, pid,ibd, biliary, gastro, portion, HSP, epididimytis, renal, pancreatits Mittelschmertz, pregnant, tortun, PUD
differential for an infant with and pain
hernia, intussusception, pyloric stenosis, hirshpsring, colic, malrotation, perforation, NEC gastroenteritis
svt
ice, adenosine0.1 mg mas 6 consider amiodaron 5mg/kg consider procainamide 15mk/kg unstable 0.5 to 1 Joul then 2 J/kg
extra abdomen causes of pain in and
pneumonia HUS, HSP, sepsis, streptococcal, abd migraine, ingestion like iron, black widow bigte
neonatal resuscitation first steps for all
position, suction, stimulation, warm, dry hr>100 is OK hr<100 give pos ventilation HR<60 give ventilation and CPR and EPi 0.01 mg/kg of epi iv/io give glucose 2k-4 mg/kg of d10 CPR at 3 t0 1
NEC
small preterm but also in term. cause UK Watch in 1st week of life for vomiting, ileus, distention, and bloody stools Plane films show loops with thickened wall pneumatodisis intestinales, air in portal vein tx is decompression, abx, and surgery