Paediatrics

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Paediatric procedural sedation parent information sheet and checklist

Thursday, August 13th, 2009

Sunshine Hospital (in collaboration with RCH) has developed and has been using for a few years now, a pediatric procedural sedation parent information sheet and checklist to better manage risk in the ED.

Dr Krieser has kindly consented to posting these documents on the OzEmedicine website where they will be printed off for Sunshine Hospital staff use, but may inspire other health services to create similar documentation for their ED staff, if they have not done so already.

parent information sheet

sedation check list

more links for ED procedures on the wiki here.

more links to patient information sheets on the wiki here.

Management of life threatening asthma in children

Wednesday, March 11th, 2009

To make life easier for ED resuscitation staff confronted with the asthmatic patient who is becoming exhausted and cyanosed, a hopefully easy to follow guideline derived from RCH and NSW NETS guidelines has been created on the Ozemedicine wiki.

see guideline here

It has been designed with links to further information on the drugs used as well as to contact details for retrieval services and the referenced articles.

Unfortunately, each hospital tends to have their own procedures for creating salbutamol, aminophylline and magnesium sulphate, but hopefully the ones outlined are easy to follow and are standard, at least in NSW and Victoria.

New online resource – Victorian neonatal handbook – free online and PDA download

Tuesday, December 23rd, 2008

Please go to the Victorian neonatal handbook website for a valuable neonatal resource which is also available as a free download for use on various PDA devices.

More links to neonatal resources can be found on the ozEmedicine wiki here.

Important Paediatric Drug Doses

Tuesday, August 26th, 2008

Cardiac Arrest

  • Adrenaline 1:10000 iv 0.1 ml/kg
  • Adrenaline 1:1000 ETT 0.1ml/kg
  • Lignocaine 1% solution iv 0.1ml/kg (1mg/kg)
  • Amiodarone iv 5mg/kg
  • Sodium bicarbonate 8.4% iv 1ml/kg
  • Atropine iv 0.02mg/kg

Supraventricular Tachycardia

  • Adenosine iv 0.1mg/kg then incremental increases of 0.1mg/kg to a maximum of 0.5mg/kg (max dose 18mg)

Anaphylaxis

  • Adrenaline 1:1000 im 0.01ml/kg (12-18 year olds give 0.5mg im; Adult 0.5-1mg im)
  • Methylprednisolone iv 1mg/kg

Croup

  • Adrenaline 1ml of 1% (L-isomer) solution (plus 3ml saline) via nebuliser
  • Prednisolone oral 1mg/kg, or,
    • Dexamethasone im 0.6mg/kg

Hypoglycaemia

  • Glucagon im/sc/iv 0.02mg/kg (max 1mg)
  • Dextrose 10% iv 4-5ml/kg


Seizure

  • Midazolam iv/im 0.15mg/kg
  • Midazolam buccal/nasal 0.2mg/kg
  • Phenytoin iv 15-20mg/kg (max 1 gram) Dilute to 6mg/ml or weaker. Infusion rate up to 1mg/kg/minute

Rapid Sequence Induction for intubation

  • thiopentone iv 2-5mg/kg, or,
    • ketamine iv 1-2mg/kg
  • suxamethonium iv 1-2mg/kg
  • (atropine iv 0.02mg/kg not all practitioners use atropine)

Sources: Drug Doses 14th Edition Frank Shann 2008;

this has now also been placed on the wiki

Intranasal fentanyl for children

Tuesday, August 19th, 2008

Sunshine Hospital has just commenced using intrasal fentanyl as an alternative analgesic for paediatric patients.

Here is a link to the policy (pdf format)

sunshine-intranasal-fentanyl-policy

and a link to the OzEMedicine wiki reference