Peds facts Flashcards by B -

Q

what is the age for neonates

A

less than 30 days of age

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Q

what is the age for infants

A

1-12 months

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Q

what is the age for children

A

1-12 years

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Q

The CO of neonates is dependent on what? and why?

A

HR

bc SV is relatively fixed by a non-compliant and poorly developed left ventricle

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Q

CO is depedendent on what

A

HR

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Q

Neonate and infants compared to adult:

HR is what?

A

faster

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Q

Neonate and infants compared to adult:

BP is what?

A

lower

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Q

Neonate and infants compared to adult:

RR is what?

A

faster

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Q

Neonate and infants compared to adult:

lung compliance is what?

A

lower lung compliance

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Q

Neonate and infants compared to adult:

chest wall compliance

A

greater chest wall compliance

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Q

Neonate and infants compared to adult:

FRC

A

lower functional residual capacity

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Q

Neonate and infants compared to adult:

ratio of body surface to body weight

A

higher ratio of body surface to body weight

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Q

Neonate and infants compared to adult:

total body water content

A

higher total body water content

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Q

Neonate and infants compared to adult:

compliance of LV

A

non-compliant (less compliant than adult)

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Q

they have large what anatomically

A

head an tongues

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Q

Neonate and infants Anatomic differences:

what is unique about the nasal passage

A

narrow

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Q

Neonate and infants Anatomic differences:

what is unique about the larynx

A

narrow and cephalad

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Q

Neonate and infants Anatomic differences:

what is unique about their epiglottis

A

longer

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Q

Neonate and infants Anatomic differences:

what is unique about their trachea and neck

A

short

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Q

Neonate and infants Anatomic differences:

they usually have prominent what in the oral cavity

A

tonsils and adenoids

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Q

Neonate and infants Anatomic differences:

are their intercostal and diaphragm muscles weak or strong

A

weak

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Q

Neonate and infants Anatomic differences:

do they have high or low resistance to airflow

A

high resistance

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Q

Neonate and infants Pharmacologic differences:

what is unique about their hepatic biotransformation

A

it is immature

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Q

Neonate and infants Pharmacologic differences:

do they have increased or decreased protein binding?

A

decreased protein binding

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Neonate and infants Pharmacologic differences: | do they have fast or slow induction and recovery?

rapid (fast)

Neonate and infants Pharmacologic differences: | do they have a large or small Vd for water soluble

large volume of distribution

Neonate and infants Pharmacologic differences: | what is unique about their NMJ

immature

where is the laryngeal location in the adult?

C3-C6

where is the laryngeal location in the per?

C2-C4

what is the narrowest part of the adult airway?

Glottis

what is the narrowest part of the ped airway

Cricoid (controversial lately)

what is the shape of the adult epiglottis?

V

what is the shape of the ped epiglottis?

Omega

what does the right main stem bronchus look like in the adult

more vertical

what does the right main stem bronchus look like in the pediatric

less vertical

Airways significance: | neonates are preferential what type of breathers

nasal

Airways significance: | the have narrow nares.. what does this mean

resistance is 12 times that of an adult

Airways significance: | what is a problem with their tongue

its large

Airways significance: | what is a problem with their glottis?

high glottis (more cephalad)

Airways significance: | what is the narrowest point of the airway in children younger than age 5

cricoid cartilage (controversal as of late)

ETT sizes ID: | Neonates

3-3.5 mm

ETT sizes ID: | infant 6 months to 1 year

3.5 - 4.0 mm

ETT sizes ID: | children 1-2 yrs

4.0-4.5 mm

ETT sizes ID: | what is the calcualtion for ETT size in peds

ETT = (16 + age) / 4 or (age / 4 ) + 4

ETT sizes: | how do you calculate the tube length at mouth

(cm / 10 ) + 5 or ( Kg / 5 ) + 12

Lung Volume | Va (mL /kg /min) of neonate? Child? adult?

Neo- 100-150 Child- 80 Adult - 60

Lung Volumes: | Frequency ( Min) of neonate? Child? adult?

Neo- 40 Child- 20 Adult- 10

Lung Volumes: | TLC ( mL/kg) of neonate? Child? adult?

Neo- 60 Child- 70 adult-80

Lung Volumes: | FRC ( mL/ kg) of neonate? Child? adult?

Neo- 30 Child- 32 Adult - 34

the decreased FRC in the infant means what with induction w/ inhalation agents

faster induction

``` Lung Volumes: Reserve volume (mL/kg) of neonate? Child? adult? ```

Neo- 20 child- 19 adult- 17

Lung Volumes: | Vt (mL/Kg) of neonate? Child? adult?

Neo- 6 Child - 7 Adult - 7

the increased closing capacity and decreased FRC make neonate prone to what?

atelectasis and hypoxia during anesthesia

why are neonates diaphragmatic breathers?

intercostals muscles underdeveloped Diaphragm is high chest cavity is small

State the HR; Systolic BP; and Diastolic BP: | Preterm

120-180 45-60 30

State the HR; Systolic BP; and Diastolic BP: | term

100-180 55-70 40

State the HR; Systolic BP; and Diastolic BP: | 1 yr

100-140 70-100 60

State the HR; Systolic BP; and Diastolic BP: | 3yr

85-115 75-110 70

State the HR; Systolic BP; and Diastolic BP: | 5 yr

80-100 80-120 70 adult values

EBV: | premature

90 mL/kg

EBV: | infant

80 mL/kg

EBV: | toddler 6wk-2yrs

75 ml/kg

EBV: | child 2yrs - 12 yrs

72 mL/kg

EBV: | adult male

70 mL/kg

EBV: | Adult female

65 mL/kg

how much blood could a 4 kg, 4 month old loose if the hot is 36 and your lower level o f acceptance is hot of 29

``` 75 mL/kg x 4 kg =300 mL 300 (36-29) / 36 = X 300 (7) / 36 = X 2100 / 36 = X 58.3 mL = X ```

how do you calculate fluid maintenance for a child

4:2:1 rule 4mL/kg for 1st 10 Kg 2mL/kg for 2nd 10 kg 1mL/kg for each kg over 20 kg

calculate the hourly fluid maintenance for a 27 kg child

4 x 10 = 40 2 x 10 = 20 1 x 7 = 7 = 67 mL/hr

State the fetal circulation

RA to RV to PA through PDA to aorta (bypass lungs) to infant | RA through FO to LA to LV to Aorta to infant

state the normal circulation post delivery

RA to RV to PA to Lungs to PV to LA to LV to Aorta to RA

what is the TBW%: | preterm

90%

what is the TBW%: | Term

80%

what is the TBW%: | 6-12 mo

60%

why are infants of diabetic mothers prone to hypoglycemia?

the infant with produce insulin in response to maternal blood sugar to control it's own blood glucose level. After delivery of the infant, the cord is clamped eliminating maternal blood flow. Now the infant will have their own stored insulin and this insulin will decrease the newborn;s blood sugar

why are infants prone to GERD and aspiration

incompetent LES

what is the most commonly used LA in infants and children i north america

Bupivacaine

what is the preferred concentration of LA for peripheral nerve block in the neonate

0.25% bupivacaine

What is the LA drug of choice for continuous infusion in the neonate?

Bupivacaine 0.1%

which LA can be used for most peripheral blocks and for caudal and epidural infusion in infants and children

Bupivacaine

what is the suggested maximum dose for bolus of injection int he caudal space or epidural space for older children and neonates? for infants?

4 mg/kg | 2mg/kg