II. Criteria: Body habitus

  1. Age: 10-12 years
  2. Length: 137-150 cm
  3. Weight: 30-36 kg (mean 33 kg)

III. Findings: Vital Signs (normal)

  1. Heart Rate: 60-120/minute
  2. Respiratory Rate: 12-25/minute
  3. Systolic Blood Pressure: 95-120 mmHg

IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation

  1. Induction (Sedation)
    1. Etomidate 10 mg
    2. Ketamine 66 mg
    3. Propofol 100 mg
  2. Paralytic
    1. Succinylcholine 66 mg
    2. Rocuronium 33 mg
    3. Vecuronium 3.3 mg
  3. Sedation Maintenance
    1. Lorazepam 1.6 mg
  4. Equipment
    1. ET Size cuffed: 6.5 mm
    2. ET Insertion depth (at lips): 18.5 to 19.5 cm
    3. Laryngoscope Blade: 2-3 Miller (straight) or Macintosh (curved)
    4. Suction catheter: 12 F
    5. LMA: 3
    6. Tidal Volume: 200-330 cc
    7. Breath rate: 12-20/min
    8. Inspiratory time: 0.8 sec

V. Protocol: Miscellaneous Equipment

VI. Protocol: Fluids

  1. IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 640-740 ml
  2. IV Fluid Crystalloid Maintenance: 74-78 ml/h

VII. Medications: Resuscitation

  1. Cardioversion
    1. First (1 J/kg): 33 J
    2. Next (2 J/kg): 66 J
  2. Defibrillation
    1. First (2 J/kg): 66 J
    2. Next (4 J/kg): 130 J
    3. Next (4-10 J/kg): 130-300 J
  3. Lidocaine
    1. Intravenous (100 mg/5 ml = 2%): 33 mg (1.65 ml)
    2. Endotracheal (100 mg/5 ml = 2%): 66 to 100 mg (3.3 to 5 ml)
  4. Epinephrine
    1. Intravenous (1:10,000): 0.33 mg (3.3 ml)
    2. Endotracheal (1:1000): 3.3 mg (3.3 ml)
  5. Atropine
    1. Intravenous (0.1 mg/ml): 0.5 mg (5 ml)
    2. Endotracheal (0.4 mg/ml) 1 mg (2.5 ml)
  6. Naloxone
    1. Intravenous (0.4 mg/ml) 0.33 mg (0.83 ml)
    2. Endotracheal (0.4 mg/ml) 0.33 mg (0.83 ml)
  7. Adenosine
    1. Initial dose (6 mg/2ml): 3.3 mg (1.1 ml)
    2. Next dose (6 mg/2ml): 6.6 mg (2.2 ml)
  8. Amiodarone
    1. Intravenous (50 mg/ml): 165 mg (3.3 ml)
  9. Calcium Chloride
    1. Intravenous (100 mg/ml = 10%): 660 mg (6.6 ml)
  10. Magnesium Sulfate
    1. Intravenous (5 g/10 ml = 500 mg/ml = 4 meq Mg/ml = 50%) 1650 mg (3.3 ml)
  11. Sodium Bicarbonate
    1. Intravenous (1 meq/ml = 84 mg/ml = 8.4%) 33 meq (33 ml)

VIII. References

  1. eBroselow
    1. http://www.ebroselow.com
  2. Broselow (2011) Broselow Pediatric Emergency Tape, Vital Signs, Inc, Totowa, NJ
  3. LA County EMS Color Coded Pediatric Drugs
    1. http://ems.dhs.lacounty.gov/ManualsProtocols/3colordrug.pdf
  4. Difficult Airway Course
    1. http://www.theairwaysite.com
  5. (2008) Fairview University - Childrens Hospital, Pediatric Emergency Drug Guide

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