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Flashcards in PICU Deck (42):
1

At what pressure does the pop off valve come off a self-inflating bag?

40-45mmHg

2

What is the first type of drugs to be used in a planned intubation?

vagolytics- atropine of glycopyrollate as the mechanical pressures of intubation/laryngoscopy causes a vagal response and bradycardia. You can give these drugs to stop that.

3

Thiopental

Pentathal, barbituate; Very fast time of onset /offset 5-10min. Primary effect is sedation. Good to control increased ICP. Bad for hemodynamics. 2-4mg/kg. No amnesia or analgesia

4

Ketamine

Sedation, amnesia, and analgesia. Not good for ICP, good for hemodynamics, good for RAD b/c bronchodilator. Causes release of catecholines and maintain bp. 1-3mg/kg. Can give IM. Can get bad dreams (can add versed). Causes increased secretions

5

Benzo and narcotic combo

Most common versed and fentanyl. Sedate without losing bp or protective airway. Cause amnesia and analgesia and sedation. Lasts for 30-45 min.

6

Dose of versed and fentanyl for procedures

0.1mg/kg versed. 2-4ug/kg fentanyl

7

Propofol

Onset 60s, offset 5-10min. Good for ICP, bad for hemodynamics. Feel great after waking up.

8

Etomidate

Best for hemodynamic instability. 0.2mg/kg. Can cause clonic activity. Can get adrenal suppression. Not recommended for kids with septic shock.

9

Lidocaine

Good for control of RAD and ICP. Optional adjunct

10

Succinylcholine

Depolarizing muscle relaxant. Antagonist to postsynaptic Ach receptors, but causes muscle twitch. duration 5-10minutes. Can cause potassium to go up. Contraindic: hyperkalemia, congenital myopathy, burns, trauma, spinal cord trauma. Advantage: very potent, very fast 60s onset, 5-10min offset. Emergency drug

11

What are non-depolarizing agents

Pancuronium, Vecuronium, ciscuronium; onset 2-3 min, last 30-40 minutes. dependent on renal excretion. Contraindic: Renal failure

12

Pancuronium

vagolytic

13

Cisatricarium

Non steroidal. Hoffman degradation, not renal or hepatic excretion. 2-3min onset time, 20min offset. More expensive.

14

Rocuronium

Non-depolarizing, more hepatic than renal. Works quickly, 1-2 min onset, 20-40min offset.

15

What is the first type of drugs to be used in a planned intubation?

vagolytics- atropine of glycopyrollate as the mechanical pressures of intubation/laryngoscopy causes a vagal response and bradycardia. You can give these drugs to stop that.

16

Thiopental

Pentathal, barbituate; Very fast time of onset /offset 5-10min. Primary effect is sedation. Good to control increased ICP. Bad for hemodynamics. 2-4mg/kg. No amnesia or analgesia

17

Ketamine

Sedation, amnesia, and analgesia. Not good for ICP, good for hemodynamics, good for RAD b/c bronchodilator. Causes release of catecholines and maintain bp. 1-3mg/kg. Can give IM. Can get bad dreams (can add versed). Causes increased secretions

18

Benzo and narcotic combo

Most common versed and fentanyl. Sedate without losing bp or protective airway. Cause amnesia and analgesia and sedation. Lasts for 30-45 min.

19

Dose of versed and fentanyl for procedures

0.1mg/kg versed. 2-4ug/kg fentanyl

20

Propofol

Onset 60s, offset 5-10min. Good for ICP, bad for hemodynamics. Feel great after waking up.

21

Etomidate

Best for hemodynamic instability. 0.2mg/kg. Can cause clonic activity. Can get adrenal suppression. Not recommended for kids with septic shock.

22

Lidocaine

Good for control of RAD and ICP. Optional adjunct

23

Succinylcholine

Depolarizing muscle relaxant. Antagonist to postsynaptic Ach receptors, but causes muscle twitch. duration 5-10minutes. Can cause potassium to go up. Contraindic: hyperkalemia, congenital myopathy, burns, trauma, spinal cord trauma. Advantage: very potent, very fast 60s onset, 5-10min offset. Emergency drug

24

What are non-depolarizing agents

Pancuronium, Vecuronium, ciscuronium; onset 2-3 min, last 30-40 minutes. dependent on renal excretion. Contraindic: Renal failure

25

Pancuronium

vagolytic

26

Cisatricarium

Non steroidal. Hoffman degradation, not renal or hepatic excretion. 2-3min onset time, 20min offset. More expensive.

27

Rocuronium

Non-depolarizing, more hepatic than renal. Works quickly, 1-2 min onset, 20-40min offset.

28

What type of pressures should you aim for when intubating an asthmatic?

tidal volume 5-6mL/kg, plateau pressure not above 35mmHg

29

How do you decrease air trapping in asthmatic?

1. Administer bronchodilator 2. increase expiratory time 3. Decrease tidal volume and minute ventilation

30

Which sedatives are good for asthmatics?

isoflurane or ketamine

31

How do you determin ET size?

Estimated size of inner diameter of uncuffed endotracheal tube (in mm) =
(Patient age in years / 4) + 4

32

How do you determine the depth of ET tube?

age/2 +12

33

What is dose of atropine in pediatric code?

0.02mg/kg

34

What is dose of adenosine in pediatric code?

0.1mg/kg

35

Amiodoarone dose in a code?

5mg/kg

36

Initial defibrillation joules?

2J/kg

37

repeat defibrillation joules?

4J/kg x2

38

Defibrillation (cardioversion)

0.5-1J/kg

39

Dose of epinephrine in codes

0.01mg/kg or 0.1ml/kg of 1:10,000 soln IV

40

Dose of epi for anaphylaxis

0.01mg/kg of 1:1000 soln IM

41

What dose of glucose bolus should be given for hypoglycemia?

2-4ml/kg of D25W over 20minut

42

Does of Bicarc

1meq/kg