EMERGENCY DRUGS CEPHALOSPORINS AMINOGLYCOSIDES

1st Generation
Epinephrine 0.01-0.03 mkd q3-5min Cephalexin 25-100 mkD q6-8h/ 250-500 Amikacin 10-15 mkD/15-25mkDq8-12
Atropine 0.02-0.03 mkd(max0.5mg) Cefadroxil 30 mkD BID(max:2g) Prep: 100/2; 250/2
Adenocard 6 mg initially; 12mg nxt Cefalothin 50-100 mkD QID Kanamycin 30-50 mkD
Adenosine 6mg/2mL Cefazolin 50-100 mkD q8 Tobramycin 6-8 mkD (Nebcin)
Ca Gluc 10% 0.1-0.2 mkd Cephradine 50-100 mkD q6-12 Gentamycin 5-8 mkD IV
Captopril 0.3-0.5 mkd q6-12h
Capoten 25mg/tab 2nd Generation
Hydralazine 0.1-0.2 mkd Cefamandole 50-100 QID
Apresoline PO: 10mg; 25 Cefaclor 20-40 mkD q8-12 MACROLIDES
IV: 20mg/amp Ceclor 125/5; 250/5 DS
L-Carnitine 50 mkd q4-6h(N) Cefuroxime IV: 200-240 mkD q8 Erythromycin 30-50 mkD
30-40mkd?? PO: 20-30 mkD BID Erythrocin 200/5; 400/5 ds; 100/2.5gtts
Carnicor PO: 1/10; 330
IV: 1/5 3rd Generation
Azithromycin 10 mkD ODx1D,5mkDx4D
Lidocaine 1.0 mkd bolus Cefotaxime 150 mkD q6-8 (menin:200)
Grp. A Strep 12mkDx5 D
20-50 ugKmin NB:<7 100mkd q 12H;
Mannitol 20% 1-2 mkd 1g q8-12 for > 12yo & 2g-adults
Clarithromycin 15 mkD q12 or
Prep 1.2% soln (1 med/mL) Claforan 500mg; 1g; 2g
7.5 mkd
NaHCO3 1.5-2.0 mkd Ceftriaxone NB 50-75mkDOD
Klaricid 125/5 (dont ref)
Naloxone 0.1 mkd Child: 50-75 mkD OD
Plain 0.4mg/1mL Meningitis LD:75mkd,80-100mkDq12-24
Neonatal 0.02mg/1mL Adult: 1-2 g OD
Nifedipine 0.25-0.5 mkdq4-6h
Nipride 0.5-1.5 ugkm**
Urecholine 2.9mg/m2/d q8 PO**
ANTI-STAPH Ceftazidime 150 mkD q 8 hrs ANTI-TB
(Fortum) < 2mo: 25-50 mkD BID INH Tx: 5 mkD liver
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
Co-Amoxiclav 40-60 mkD Cefoperazone 100-150 mkD Nicetal 100/5
Augmentin 156/5; 312/5 Child: 50-200 mkD BID Primafort 100/5
Stafloxin 100-200 mkD Adult: 2-4 gkD q12 Odinah 150/5
Vancomycin 40-60 mkD Cefobis Trisofort 200/5
Cloxacillin 50-100 mkD q6 Cefoxitin 50-100 mkD q6-12 Pyrobin H 150/5
Prostaphlin-A 125/5 Mefoxin 1 g/vial Comprilex 200/5
Orbenin 250; 500 Ceftizoxime Child: 40-80 mkD bid-qid Ethambutol 20mkD optic neuritis
Oxacillin 100-200 mkD IV Adult: 0.5-2 g/d Myambutol 200/5
(Prostaphlin) 2-4 doses IV/IM Ethambin 125/5
Cefixime 3-6 mkD BID Isoetham 150/5
OTHER B-LACTAMS Tergicef 100/5 (50mg/ml) Ethambin/INH 150/5; 125
Cefdinir 9-18 mkD q8 Rifampicin 10 mkD (liver)
Imepenem 60-100 mkD q 6 or 8 Omnicef 50mg/sachet; Rimactane 100/5; 200/5
NB: 20 mk q 12 100mg/cap 150; 300; 450; 600
Piperacillin (Cypercil) Cedax 9 mkD OD (180/5) Meningo Px:
Less Serious: 100-200 MKD q6 Cefetamet 20 mkD OD q12 Adult: 600 q12 x 4 doses
Serious: 200-300 MKD Globocef 250/5 1-12yo: 10 mk q12 x 4 doses
Vancomycin 40-60 MKD (give in 2h) q 8 or 12 4th Generation 3mo-1y: 5 mk q12 x 4 doses
Meropenem 20 mkd q 8 or 60 mkD q 8 hrs Cefepime Streptomycin 20-30 mkD OD IM ototoxic
40 mkd q 8 hrs newborn septic for severe infection, 50 mkd q8 PZA 15 mkD
2mo old, BW <40kg = 50 mkq12x10d
Newborns 30 mkd q 8 hrs Give PO pre breakfast
 ANTI-HELMINTHIC
ANALGESICS PENICILLINS Oxantel pamoate 10-20 mkd
Quantrel 100/5; 100
Fentanyl Low: 2 mkD PCN: 50-100TUKD or Tetramizole 2.5-5 mkd SD
Mod: 2-20 mkD 25-30 mkD TMZ 25mg/10mL
High: 2-50 mkD 625mg = 1 MU Mebendazole 100 mkd BID x 3 days
Sublimaze (Janssen): 50ug/2mL 250/5 = 400 TU Antiox: 100; 500mg/tab; 20mg susp
Ibuprofen 5-10 mkd q6-8 312.5/5= 500 TU Combantrin 125mg; 250mg/tab
Dolan FP 100/5 500mg = 800 TU 125mg/5mL susp
Mefenamic acid 3-5 mkD Oral PCN 100-200 TUKD >15yo = 500 mg
Ponstan 50/5 Pentacillin 50/5; 500mg 10-14yo = 375 mg
Midazolam 0.1 mkD Sumapen 25/5; 250; 500 5-9 yo = 250 mg
Dormicum IV: 5/1;5/5;15/3 Megapen 50 TU/mL gtts 5 yo = 125 mg
PO: 5mg/tab 312.5/5; 625mg
Morphine 0.1-0.2 mkD Amoxicillin 20-50 mkD q8 ANTI-VIRAL
Morphine 10/mL 80-90mkD-OM Methisoprinol 50-100 mkD
Nalbuphine 0.1 mkD Nafcillin 100-200 mkDq6 Isoprinosine 250/1; 500
Nubain 10/mL Stafloxin 100-200 mkD Inosiplex 50 mkD
Pancuronium 0.04-0.1 mkD Ampicillin 100-200 mkD Immunosine 250/5
Promethazine (NB: 50-100 BID; Amantadine 5-8 mkD
Phenergan IV: 50/2 men: 300-400 mkd q6) Symmetrel 50/5
PO: 1/1; 10mg Unasyn 25 mkD q 6 hrs Virazole 10 mkD
Ketorolac 0.25 mkd q 6 hrs Ampicin/Pentrexyl/Aldribid Acyclovir 10-15 mkD q6 x 5D
Bacampicillin 25-50 mkD Zovirax 250/5; 200
Penglobe 200/5
ANTI-ASTHMA ANTI-DERMATOSES COUGH
Aminophylline LD: 8-10 mk
MD: 3-5 Hydrocortisone 1% TID x 2 wks Ambroxol 1.2-1.6 mkD q12
Drip: 0.4-0.9 mkH Hytone/Hydrotpic/Eczacort Mucosulvan 15/5; 7.5/1.5
Neonate: 1 mkd q8 or 2 mkd q12 Betamethasone BID-TID Zobrixol 15/5; 7.5/1.25
Apnea: LD: 5-6 mkd (o.5-0.9 m/k/hr Betnovate/Diprolene/Diprosone Salvotran 15/5; 30/5
infusion) Fluocinolone acetonide BID-TID Bromhexine 7-12y = 1 tsp TID
MD: 2 mk 12h post-LD Aplosyn 10; 25; HP 2-6y = tsp TID
Prep: 250/10 Synalar 10; 25; HP Bromulex 4mg/5mL; 8mg
Drip: eg: 5kg at 0.4 mkH in 8h drip: Mometasone furoate OD SCMC 20-30 mkD
5 x 0.4 x 8 = 16mg in 8h Elica/Momate Loviscol 50/1; 100/5
if IVF rate is 5cc/h, fill soluset Clobetasole propionate Solmux 40/1; 200/5
with 40cc IVF+ 16mg Dermovate Cemetol 200/5
Amino (0.64mL) Diflucortolone valerate BID-TID
Theophylline 3-5 mkd Nensona Erdosteine 10 m/dk/d BID
Nuellin 80/15; 50; 125; 250 Desoximetasone BID-TID 175mg/mL
Terbutaline SQ: 0.005 mkd Esperson
PO: 0.075 mkd Triamcinolone acetonide BID-TID
Drip: 0.003 mkH Kenacort A/Ladercort A
Bricanyl IV: 0.5/1 DIAZEPAM DRIP
PO: 1.5/5; 2.5
Salbutamol 0.12-0.15 mkd 0.3 mkH dilute in NSS makes 0.1mg/mL
Ventolin 2/5 sy; 1.2/5 exp; 2 conc = mg/total vol (mL
Librentin 2/5; 2mg
Prox-S 2/5; 2mg
Atrovent 4-8gtts/mL NSS
ANTI-HISTAMINES DIURETICS Prep: Dopamine: 200/5
Diphenhydramine 3-5 mkD TID-QID Conc Dopa D5W
Benadryl IV: 50/1x3 dose Furosemide 1.0-2.0 mkd S 800 1 cc 49 cc
PO: 12.5; 25; 50 Lasix 20/2; 40mg DS 1600 2 cc 48 cc
Methdilazine 0.3 mkD q12-q6 Frusema 20/2; 20mg; 40 QS 3200 4 cc 46 cc
Tacaryl 4/5; 4; 8 Diazoxide 5-10 mkd
Clemastine 0.05 mkD q12 Diazoxide 300/2 Prep: Dobutamine: 250/2
Tavegyl 0.5/5; 1mg Acetazolamide 20-30 mkD Conc Dobu D5W
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
Virlix 10mg/1mL Hydrochlorothiazide 1-2 mkD
Loratadine 2-12yo, < 30k: 1 tsp OD Dichlotride 25mg; 50mg/tab Computation for concentration:
>30k: 2 tsp OD Mannitol 20% 1.5-2 gkD or 5cckd
Claritin 5mg/5mL 200g/1L; (1gm = 5 cc; 0.5-1gkd) 1. D5W 250 + 200 mg/amp
Ketotifen 0.025 mkd q12 200/250 = 0.8 mg/cc = 800 ug/cc
Zadec 1mg/5mL; 1mg 1 cc = 60 ugtts
Zaditen 0.2mg/1mL; 1 DOPAMINE DRIP conc = 600/60 = 13.33 ug/ugtts
2. Lidocaine 2%
ATROPINE SULFATE 1-5 ug/k/min = VD, inc renal & splan circ 2 g/100 mL = 20 mg/mL
Pedia 1-2 mg SQ q 20min 5-10ug/k/min = inotropic; no effect on HR
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

Dexamethasone 0.2-0.4 mkd Vitamin K 0.3 Mkd (max 5 mg) x 3 dys Aeknil 300mg/2mL
Decadron 4/1 Afebrin 120mg/5mL; 325mg; 500
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
Solu-cortef 100/2; 250/2 (Max 200 Mkd in 10 min) Crocin 125mg/5mL; 500mg
Act-o-vial 100 IV: 100/1 (9 el. Ca/ml or 0.45mg Defebrol 60mg/0.6mL; 120mg/5mL
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
1 mkD (BA) Tempra 120mg/5mL; 60mg/0.06mL
Methylprednisolone 1.5 mkD q 6 hrs Iron Tx: 4-6 MKD Tylenol 120mg/5mL
Px: 1-2 MKD Winadol 120mg/5mL; 500mg
Iberet 500 mg (26.25 elem Fe)
ALBUMIN Odiron 50mg/10mL; 25mg/5mL SALICYLATES
Fer-in-sol 15mg/0.6ml; 18mg/5mL
Albumin: 1 g/K/dose Propan 25mg/5mL Anti-rheumatic 65-130 mkD
Alburein 12.5g/50mL (25%) Ferlin 30mg/5mL; 15mg/1mL Asaped 81mg
Incremin 30mg/5mL Ascriptin 325mg
Formula: Desired-Actual x 1.2 x Wt Polyvifer 10mg/1mL Aspirin Gr V Gr 1 = 65 mg
Albumin 0.5-1.0 g/K (max 6 gKD) Neo-Novaldin 325mg
Albumer/Albutein 50/1 (5%) Glucagon 0.25-0.3 mkd Superin 180mg/5mL; 3g
250/1 (25%) 0.3 mkd-1mg in IDM
1 mg (1 U) vial
LUMBAR TAP HS METHOD for IVF Infusion BALLARDS MATURITY TESTING
Pressure (in cmH2O)
G 22 (1 ) = gtts in 21 sec 2.5-10kg 100cc/k/day Score AOG (wks)
G 22 (3 ) = gtta in 39 sec 10-20kg 1000cc+50cc/k over 10k
G 20 (3 ) = gtts in 12 sec >20kg 1500cc+20cc/k over 20k 5 26
10 28
WBC correction in traumatic tap: TF/4 = cc/hr or ugtt/min 15 30
Periph WBC x 1000 = WBC 20 32
5,000,000 1000 RBC Phototx +20% 25 34
Tachypnea +25-50% 30 36
C/I: increased ICP Fever +12% q 1oC > 37.5oC 35 38
severe CP depression Hypermetabolic +25-50% 40 40
infected skin Burns +14% for 1st Degree 45 42
decreased platelet count or blood d/o Sweating +10-25% 50 44
brain abscess
CHARACTERISTICS OF
colorless, 50-80 mmH2o, WBC 5/mm3 CHON PROXIMAL & DISTAL SBO
<45 Glucose 60-75% of blood glucose KVO: ugtt = 3.5
gtt = 10 HIGH SBO LOW SBO
Acute onset less acute
PHOTOTHERAPY Prominent vomiting less prominent
Indication: PT: 10 mg% bilirubin Vomit not feculent often feculent
FT: 15 mg% bilirubin Pain frequent less frequent
Complications: minimal distension prominent
osmotic diarrhea
rashes
bronze baby syndrome
dehydration
SA = Wt x 4 + 7 x 400 (renal) RANSONS CRITERIA for CRITERIA FOR AMI
Wt + 90 ACUTE PANCREATITIS
1.typical pain: retrosternal, severe, pain
Men SA x 1500 On Admission: lasting >30min, unrelieved by nitrates,
Preterm SA x 1200 cold, clammy perspiration
CHF SA x 800 1. age > 55 yrs 2. evolutionary ST elevation followed by
Cardiac SA x 200 2. leukocytosis > 16,000 Q wave formation and ST segment
Renal SA x 400 + 24h UO 3. hyperglycemia > 200mg/dL inversion
MF < 2yo = SA x 1500 (11mmol/L) 3. elevation of serum CPK-MB
> 2yo = SA x 1200 4. serum LDH > 400 IU/L
5. serum AST > 250 IU/L Labs:
0-5 kg wt x 0.05 + 0.05 Onset Peak Duration
6-10 kg wt x 0.04 + 0.1 During the initial 48hrs: CPK-MB 4-6h 12-24h 24-48h
10-15k wt x 0.03 + 0.2 SGOT 8-12h 36-48h 3-5days
15-20k wt x 0.02 + 0.3 1. hematocrit fall > 10% LDH 12-24h 2-4days 7-10days
2. fluid sequestration > 4000 mL
CRITERIA FOR RHEUMATIC FEVER 3. hypocalcemia < 8mg/dL (1.9mmol/L)
4. hypoxemia (PO2 <60mmHg)
Major: carditis, polyarthritis, chorea, 5. BUN rise >1.85mg/dL (>1.8mmol/L)
subcutaneous nodules, erythema marginatum post IVF
6. hypoalbuminemia < 3.2g/dL (32g/L)
Minor: hx of RF/RHD, arthralgia, fever,
elevated ASO, CRP & ESR, prolonged
PR interval, (+) culture of Grp. A strep
 ABG
H= 24 x pCO2 CPAP
HCO3 pH 7.35-7.45 = 7.4
TFR = wt x TV(10-15) x RR x IE ratio(2) pCO2 35-45 = 40
Chronicity: H 40 ; if < 0.3 = chronic + 2000 (2L) HCO3 22-26 = 24
pCO2 0.3-0.7 = ac/chr FiO2 = CA (0.2) + 02 (1) x 100 O2 80-100
> 0.8 = acute TFR Neonates: 7.3-7.4; 35-45; 24-26
CA = 100 FiO2 x TFR
Oxygenation: 79 Metabolic Acidosis:
80-100 adequate pCO2 = 1.5 (HCO3) + 8.4 2 limit 10
60-80 mild hypoxemia O2 = FR CA Metabolic Alkalosis:
40-60 moderate ET Size: > 2 yo = age(yrs) + 16 q 1meq/L inc HCO3 there is 0.5-1.0 increase in
< 40 severe 4 pCO2 limit 55
HR RR Respiratory Acidosis:
2-12 mo = <160 < 2 mo = up to 60 Acute: 3-4 meq/L inc HCO3 q 10mmHg inc
1-2 yo = <120 2mo-2yr = 50 pCO2
2-8 yo = <110 1-5 yo = 40 Chron: 0.4 meq inc HCO3 q 10mmHg
inc pCO2
IE: 60/RR - IT Respiratory Alkalosis:
IT Ac: 2-4meq dec HCO3 q 10mmHg dec
pCO2 limit 18
PEFR Chr: 0.5meq dec HCO3 q 10mmHg dec
Ht= x 100 x 5 + 170 (F)/175 (M) pCO2

% PEFR = actual x 100 def: 0.3 x ABE x wt (half correction)

expected
JAUNDICE
VITAL SIGNS INTUBATION/EXTUBATION
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
-------------------------------------
2-12 mo 120-140
4
Criteria to rule out physiologic jaundice: 1-2 yo 100-120
PT: 2 or 2.5
1. Clinical jaundice in the 1st 24 hrs of 2-8 yo 90-110
FT: 3 or 3.5
life. II. RR
2. Increase in total serum bilirubin at <2 mo up to 60
ET LENGTH
> 5 mg/dL/day (85 umol/L). 2mo-1yr 50
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
(1/4 1st hr; 7 hrs)
1. Febrile
2mo-2 yo:
2. Afebrile
Mild Pneumonia: Mild Moderate Severe
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
1. Fever + non-specific ssx; (+)
Severe Pneumonia: Hydrite 1 tab in 100cc water = 8h
tourniquet test
Admit, give IV/IM Benzyl PCN, Glucost 1 sachet in 100cc water = 8h
2. Gr. 1 + spontaneous bleeding
Tx fever, tx wheezing, Oresol 1 sachet in 1L water = 24h
3. Gr.2 + manifestations of circulatory
supportive care, reassess daily Glucolyte 1 sachet in 200cc water
failure: rapid, weak pulse; narrow
pulse pressure; HPOT; cold, clammy
Very Severe Pneumonia:
extremities
Admit, give O2, Chloramphenicol,
4. Profound Shock with undetectable BP
tx fever and wheezing,
& pulse
reassess BID (q 15min if possible) FLUIDS AND ELECTROLYTES
Days 1-5: petecchiae, fever
< 2 mos: 1. Hypotonic: D5W; D5NM; D5 0.3NaCl;
Days 5-7: bleeding
Severe Pneumonia: D5 IMB; Isolyte; D5 Maintresol
> Day 6 : shock
Hospitalize, keep warm, 2. Isotonic: D5LR; D5 NSS; PLR; PNSS
give 1st dose antibiotic Benzyl PCN/ 3. Hypertonic: D50W; D10W
CLASSICAL DENGUE FEVER
Garamycin/Gentamycin
1. Thrombocytopenia not < 100T
2. Hemoconcentration not > 20% of
baseline
IV FLUIDS IVF OF CHOICE ELECTROLYTES

Na K Cl HCO3 Ca PO4 LBM PLR Na = 135-145 meq (RV= 136 meq)

IMB 25 20 22 23 3 3 Vomiting D5 NSS K = 4-5.6 meq (RV= 4 meq)
NM 40 13 40 16 3 3 Maintenance D5 NM Ca = 8-10 meq
NSS 154 154 BA D5 0.3% NaCl Cl = 98-106 meq
LR 130 4 109 28 3 3 Fever & Sweating D5 0.3% NaCl;
NMR 40 30 Drowning D5W Deficit = (desired-actual) x Wt x 0.6
IsolyteM 40 35 40 Ascitis D5W; D10W
IsolyteP 25 20 20 CHF D5 NSS Adult = desired-actual x 350
PLP48 25 20 22 HPN D5W/D5LR(BP) 3
0.3% 51 51 CHF (NPO) D5 NSS Maintenance: Na = 3 meq/kg
0.6% 102 102 2o to HPN D5W K = 2 meq/kg
0.45 77 77 Heat Stroke D5 NSS
0.9% 154 154 Burns PLR Na/K deficit is given in 3 days
ORS 90 20 80 30 (20 gluc) Azotemia D5W Na/K delivery = 0.1-0.4 meq/kg
P-lyte90 90 20 80 Inc BUN D10W Full incorporation = 40 meq/L
P-lyte Pl 45 20 35 Bleeding D5 LR
UTI D5 NSS
Na = 1 meq = 23 mg Profuse Bleeding D5 LR
K = 1 meq = 39.1 mg Dengue Fever D5 0.3% NaCl
DM PNSS
IBW
MOTOR GRADING COMPOSITION OF BODY FLUIDS
2-12 mo = age in mo x 10
= wt in lbs 0 no movement Na K Cl HCO3
< 6 mo = age in mo x 600 + BW 1 flicker of contraction with no Gastric 50 10-15 150 0
= wt in gms associated Panc 140 5 50-100 100
6-12 mo = age in mo x 500 + BW movement at a joint Bile 130 5 100 40
= wt in gms 2 movement present but cant Ileosto 130 15-20 120 25-30
< 1 yo = Age (mo) + 9 sustain against gravity Diarrh 50 35 40 50
2 2 movement against gravity Sweat 50 5 55 0
> 2 yo = age in yrs x 2 + 8 but not with resistance Blood 140 4-5 100 25
= wt in kg 3 movement against some Urine 0-100 20-100 70-100 0
= age in yrs x 5 + 17 resistance
= wt in lbs 4 movement against full resistance Osm = 2 (Na meq/L + K meq/L) +
Urine mg/dL glucose mg/dL
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
NB 45-50 cal/kg 1-11 mos 110-115
3-10kg 60-80 1-2 yrs 100-110 Normal KIR: 0.1 0.3
10.15 45-65 3-6 yrs 90-100 Vit K = 0.3 mg/kg for IV antibiotics >7 D
15.25 40-45 7-9 yrs 80-90
25.35 35-40 10-12 yrs 70-80 Ca gluconate - 1 cc/kg/shift
35.60 30-35 13-15 yrs 55-65
> 60 25-30 16-19 yrs 45-50 Maintenance/ DAY: 30X WT
9
MF = BCE x Wt x 1.5 = cc/hr PROTEINS RDA
24 or ugtt/min 0-5 mos 2.5 g/kg/day Ca deficit - 53-75 mEq/k/day
6-11 mos 2.5-3.0 Ca requirement - 27-32 mEq/day
Fever = +12% for every oC 1-6 yo 2.0-2.5
rise > 37.5oC 7-12 yo 1.5-2.0 Wt x dose
Hyperventilation/dyspnea = + 25% 13-15 yo 1.5 9.8 in 24H
Bronchial asthma = + 50% 16-19 yo 1.0-1.5
Bililight therapy = + 20% Eg. 75 mEq x 3 kg in 24 H
Milk Formula CHON In q shift = 75 mEq x 3 kg = 75 mEq
Similac 20 cal 1.5/100 3 shifts
NAN 20 1.5/100 = 75 mEq = 8.3 cc = 72 mEq
S-26 20 2.25/100 9 (1 cc = 9 mEq)
Pre-NAN 21 2/100
BM 22 1.1/100 Ideal tracheal aspirate: EC <25
Enfalac 21 2.25/100 PMNs >10

Max steroids for NS : 2 mkD or 60

Mkm 4-6 wks
ALL HIGH RISK PROTOCOL Anaphylaxis ANTHROPOMETRY
1. Body Weight
PHASE epinephrine. A. Ideal Body Weight
induction 1:1000 At birth 3000 gms
consolidation 0.01 mkd max of .5 ml IM < 6 mo (g) age in mo x 600 + BW
maintenance 6-12 mo (g) age in mo x 500 + BW
diphenhydramine Nelson's:
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
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
L aspariginase 6mg/m2 for 9 doses 1-2 mkD up to 50 mg IV q 6H
(3 doses per week; mwf/mtw) B. Expected Body Weight (up to 1 mo)
Hydrocortisone Term EBW=(age in days-10)
5-10 mkd up to 100-500 mg IV q 4-6H x 20 + BW
Preterm EBW=(age in days-14)
x 15 + BW
Where: 10=time to recover over
physiologic wt loss
20=g/day gained
C. Estim wt
4-5mo 2 x BW 5 yo 6 x BW
1 yo 3 x BW 7 yo 7 x BW
2 yo 4 x BW 10 yo 10 x BW
3 yo 5 x BW
ASTHMA CLASSIFICATION SILVERMAN'S SCORE CHF CLASSIFICATION
BASED ON SEVERITY 0 1 2
Flaring - min marked *Anatomic
intrmtnt persistent Lower chest I acquired
mild mod severe Retractions - visible marked II congenital
Upper chest
day sx <1/w >1/w daily daily Retractions - synch in- seesaw *Physiologic (disturbance in)
night sx 2/mo >2/mo >1/w >1/w drawing A heart rhythm and conduction
PEFR exp 80 80 60-79 <60 Xyphoid B myocardial contraction
PEFR var <20 20-30 >30 >30 retractions - visible marked C clinical syndrome (HPN,DM)
FEV1 80 80 60-79 <60 Grunting - steth ears
(audible) *Functional
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
Abbot,wyeth = 1:2 MJ & Nestle = 1:1 1. Improvement in CXR
1. Initially CPAP is set @ 6cm water. If 2. AABG showing PO2 >/= 50 mmHg
MILK CAL CHON g FAT CHO there is no inc in PO2 in 15 min 3. Blood PH >/= 7.3
alfare 72/dL 2.5 3.6 7.8 pressure must be increased in 2cm 4. PCO2 </= 55 mmHg
bm(t) 699/L 9.09 41.96 72.7 increments to a maximum of 5. Hgb 12-15g% or Hct 36-45
75/dl 1.1 4.5 20/oz 10cm. (If by ETT) or by 12cm (in
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
caro syr 120/oz 31 reduce pressure. PaO2 > 70
corn oil 813/dL 82 3. If 10-12cm water pressure is 2. With FiO2 of 40%, reduce pressure
enfalac 67.6/dL 2 3.5 7.4 attained and if PaO2 reamins by increments of 2 cm water every
21/oz 2.25/dl under50, FiO2 must be increased 2-4H until pressure of 2-3cm
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
nan1 67/dL 1.2 3.6 7.5 remains less than 50 in 100% FiO2 with FiO2 of 15-50%
20/oz 1.5/dl with 10-12cm water.
nan ha 67/dL 1.51
neosure 22/oz *If CPAP fails under non invasive
nutren jr 100/dL 3 3.9 13.3 method, an ETT must be inserted.
prenan 80/dL 2.3 4.2 8.6 *If CPAP fails w/ ETT, mechanical
21/oz 2/dl ventilation is indicated.
promil 81/dL 2.4 4.1 8.9
s26 20/oz 2.25/dl
s26lbw 100/ 2.4/dL
125ml
24/oz
CSF Normal Values ELECTROLYTE COMPUTATION ET Tube Sizes and Distances
I. POTASSIUM According to Infant Weight
OPENING Pressure normal =4-5.6 meq (4)
Newborn 80-110 mm H2O N K deliverance = 0.1 - 0.4 meq/kg
Infant <200 mm H2O Weight (gms) l.D. (mm) Depth (cm)
Deficit = (KD-KA) x wt x 0.6 500-1000 2.5 N 7.0
GLUCOSE Maintenance K= 2 x wt 1000-1400 3.0 7.5
Premature 24-63 mg/dl Total K def = deficit + maintenance 1400-1900 3.0 8.0
(csf-bld ratio 55-105%) Full incorporation: 40meq/L or 1900-2200 3.5 8.5
Term 44-128 mg/dl 20meq/500cc 2200-2600 3.5 9.0
(csf-bld ratio 44-158%) K INFUSION RATE 2600-3000 3.5 9.5
K delivery = ivf rate x K in ivf / vol/ wt 3000-3400 3.5 10.0
PROTEIN normal=0.2-0.4meq/kg 3400-3700 3.5 10.5
Premature 65-150 mg/dl II.SODIUM 3700-4100 4.0 11.0
Term 20-170 mg/dl maintenance Na=3 x wt 4100-4500 4.0 11.5
maximum target/day=10 meq >4500 4.0 12.0
WBC ct Na = 1 mEq = 2.3 mg/dl
Premature 0-25 /cumm K = 1 mEq = 3.91 mg/dl
(57 % PMNs) NaHC03= gr x=650 mg=7.7 meq
Term 0-22 /cumm gr v=325
(61% PMNs) III. CALCIUM normal = 8-10 meq
IV. CHLORIDE normal = 98-106 meq
V. CO2 normal = 15 meq
DOUBLE VOLUME EXCHANGE EFW GROWTH
TRANSFUSION I. WT GAIN
station age wt gain length hc
= KBW x EST. Blood vol. x 2 fundic ht (in) - 13 x 155 - (g/day) (cm/mo) cm/mo
12 0 0-3 mo 30 3.5 2
materials: 11 + 3-6 mo 20 2 1
1. NGT fr. 5 #1 (umbilical cath.) 6-9 mo 15 1.5 0.5
2. Three way stop cock normal wt for term: 2500-3800 g 9-12mo 12 1.2 0.5
3. FWB 1-3y 8 1 0.25
4. suture Naloxone 4-6y 6 3/y 1/y
5. 50cc syringe Narcan cc=0.1 x efw
6. Ca gluconate ----------------- II. Nails 1cm/3mo
7. HGT strip 0.4 III. Hair 1cm/mo
given to bb whose mothers were IV. Liver span
given Demerol with in 4 hrs PTD 1 w : 4.5 5 cm
12 yo : M 7-8 cm F 6-6.5
LBW 2000-2499 >12 yo: M: 0.032 x wt(lbs) + 0.18
VLBW 1500-1999 x ht (in) - 7.86
ELBW 1000-1499 F: 0.027 x wt + 0.22 x ht - 10.75
V. Gallbladder
length infants: 1.5-5.5 cm
adolesc: 4-8 cm
width neonates: 0.8 cm
all ages : 0.5-2.5
AGE FREQUENT PATHOGENS (IN ORDER OF
GROUP FREQUENCY)
ANTI-AMOEBIC
Neonates Group B streptococcus, Escherichia coli, other gram-
(<1 mo) negative bacilli, Streptococcus pneumoniae, Haemophilus Metronidazole 35-50 mkD (7.5 mkd)q8
influenzae (type b,[*] nontypable) < 7 or <1.2kg = 7.5 mkDq12
13 mo > 7 or > 2 g = 30 mkD
Flagyl PO: 125/5; 250
Febrile Respiratory syncytial virus, other respiratory viruses Servizole 200mg/5mL
pneumonia (parainfluenza viruses, influenza viruses, adenoviruses), Etofamide 15-20 mkD
S. pneumoniae, H. influenzae (type b,[*] nontypable) Kitnos 40/5; 250; 500
Afebrile Chlamydia trachomatis, Mycoplasma hominis,
pneumonia Ureaplasma urealyticum, cytomegalovirus Cotrimoxazole 6-20 mkD bid (TMP)
Clindamycin <7d.o./<2kg:10mkD
312 mo Respiratory syncytial virus, other respiratory viruses 10-40mkDq6-8
(parainfluenza viruses, influenza viruses, adenoviruses),
S. pneumoniae, H. influenzae (type b,[*] nontypable), C.
Dalacin C 75/5ml
trachomatis, Mycoplasma pneumoniae, group A Chloramphenicol 50-75 mkD
streptococcus Chloromycetin
Tetracycline 40-60 mkD
25 yr Respiratory viruses (parainfluenza viruses, influenza
viruses, adenoviruses), S. pneumoniae, H. influenzae
(type b,[*] nontypable), M. pneumoniae, Chlamydophila
pneumoniae, S. aureus, group A streptococcus

518 yr M. pneumoniae, S. pneumoniae, C. pneumoniae, H.

influenzae (type b,[*] nontypable), influenza viruses,
adenoviruses, other respiratory viruses

18 yr M. pneumoniae, S. pneumoniae, C. pneumoniae, H.

influenzae (type b,[*] nontypable), influenza viruses,
adenoviruses, Legionella pneumophila
Other Antibiotics Antacids GLUCOSE INFUSION RATE

ciprofloxacin 10 mkd q 12 hrs Cimetidine 10-20 mkD GIR: RATE X DEXTROSITY

Tagamet syr 200mg/5ml; WT X 60
Co-trimoxazole 8-10 mkD BID (based on TMP) 100mg/5mL PERIPHERAL LINE: 5-6 CENTRAL LINE 9-12
Triglobe 45 mg/5mL
Bactrim 160 mg/5mL; 40 Ranitidine 4-5 mkD q 8 Dextrosity d5 50
mg/tab; 80 mg/tab Zantac IV 50 mg/2mL D 7.5 75
Macrobid 40mg/5 mL PO 150mg; 300 mg D10 100
D50 500
Clindamycin : 30 mkD for osteomyelitis Omeprazole 0.6-0.7 mk OD
30-50 mkD q 8 or 6 Losec 20 mg/tab; 40 mg/tab Converwsion:
Granules: 75mg/5mL 150/mL Conc desired-actual x 2 x total vol
Famotidine 0.7 mkd q 12 1000
H2Bloc 20mg/2mL
Eg: d10- d5x2= 0.1
Chloramphenicol 50-100 mkD Lanzoprazole 15-30 mg/24 hrs
Chloromycetin 25 mg OD PO Conversion: d7.5= 0.055
Chloramol Prevacid FDT D10= 0.11

Tetracycline 40-60 mkD Anti emetic

Metoclopramide 0.1 mkd q 8 hrs Calories: D5 0.2 kcal/cc
D7.5 0.3
D10 0.4
D12 0.5
PULMONARY VOLUMES BLOOD TRANSFUSION ACTUAL RETIC COUNT (ARC)

1. Total Volume (TV) = 500 mL FWB 20 cc/k (max) Actual Hct x reticulocyte ct
= volume inspired or expired with Desired Hct
each normal breath Vol = desired actual Hb x 6 x Wt
2. Insp. Reserve Volume (IRV) = 3.0 L = desired actual Hct x Wt RETICULOCYTE INDEX = Arc / 2
= volume that can be inspired over = Hct / ret ct x 2
and above the TV rate = vol x 12 gtts/mL = gtts/min
3. Exp. Reserve Volume (ERV) = 1.1L 60 min x 4h > 2 = hemolysis
4. Residual Volume (RV) = 1.2 L < 2 = BM suppression
= volume that remains in the lungs PRBC 10-15 cc/k
after maximal expiration 15 cc/K in neonates
5. Dead Space = 150 mL Vol = desired actual Hb x 2 x Wt DOUBLE VOLUME EXCHANGE
a. Anatomical: volume of the = desired actual Hct x Wt TRANSFUSION
conducting airways Desired Hct = volume/wt + Actual Hct
b. Physiological functional = KBW x estim body vol x 2
measurement; volume of the lungs Sedimented RBC 15 cc/k
that does not eliminate CO2 PARTIAL EXCHANGE TRANSFUSION
(usually greater in lung diseases Platelet Conc: 1 U / 6 KBW
with V/Q inequalities) 1U = 30-50 cc (raises platelet ct by 10T) = KBW x estim vol x Hct A-D
Actual Hct
FFP = Fluid rate (5-20 cc/k/h in 4h) 1O-15
CC/KG 1 u = increases Hgb by 2; Hct by 3
CRYOPPT: 1 UNIT/7 KG
 Insulin Drip DOPA- DOBU COCKTAIL

Secure regular insulin (100 iu/mL)

Get rate of dopa according to desired dose
Prepare as follows: Get volume of dobu according to desired
dose using
1. aspirate 0.1 mL from vial + 0.9mL NSS to make
10 iu/mL Vol= __wt x RD x 60__
2. aspirate 0.1mL from (1) + 0.9 NSS to make Dopa rate conc. of dobu
1 iu/mL

Start dose at 0.05 iu/ k/ H Eg.: wt 3kg , Dopa 15, Dobu 15

Ex. Weight 1.55 kg Dopa 1 cc

1.55 x 0.05 = 0.08 mL/H Dobu 0.8 cc
Calculate for vol nedded in 8 hours D5Water 48.2 cc
0.08mL x 8 = 0.6 mL 50cc at 3.4 cc/hour

Instructions: aspirate 0.6 ml from (2) + 7.4mL to

make 8 mL and run at 1 mL/ hour