II. Criteria: Body habitus

  1. Age: 11-18 months
  2. Length: 74 to 84.5 cm
  3. Weight: 10-11 kg (mean 10.5 kg)

III. Findings: Vital Signs (normal)

  1. Heart Rate: 110-170/minute
  2. Respiratory Rate: 20-30/minute
  3. Systolic Blood Pressure: 70-110 mmHg

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

  1. Induction (Sedation)
    1. Etomidate 3.2 mg
    2. Ketamine 20 mg
    3. Propofol 32 mg
  2. Paralytic
    1. Succinylcholine 20 mg
    2. Rocuronium 10 mg
    3. Vecuronium 1 mg
  3. Sedation Maintenance
    1. Lorazepam 0.5 mg
  4. Equipment
    1. ET Size cuffed (preferred): 3.5 mm
    2. ET Size uncuffed: 4.0 mm
    3. ET Insertion depth (at lips): 11-12 cm
    4. Laryngoscope Blade: 1 Miller (straight)
    5. Suction catheter: 8-10 F
    6. LMA: 2
    7. Tidal Volume: 65-105 cc
    8. Breath rate: 15-25/min
    9. Inspiratory time: 0.7 sec

V. Protocol: Miscellaneous Equipment

  1. Urinary Catheter: 8-10 F
  2. Nasogastric Tube: 8-10 F
  3. Chest Tube: 16-20 F

VI. Protocol: Fluids

  1. IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 200-220 ml
  2. IV Fluid Crystalloid Maintenance: 41-43 ml/h

VII. Medications: Resuscitation

  1. Cardioversion
    1. First (1 J/kg): 10 J
    2. Next (2 J/kg): 20 J
  2. Defibrillation
    1. First (2 J/kg): 20 J
    2. Next (4 J/kg): 40 J
    3. Next (4-10 J/kg): 40-100 J
  3. Lidocaine
    1. Intravenous (100 mg/5 ml = 2%): 10 mg (0.5 ml)
    2. Endotracheal (100 mg/5 ml = 2%): 20-30 mg (1.0-1.5 ml)
  4. Epinephrine
    1. Intravenous (1:10,000): 0.1 mg (1 ml)
    2. Endotracheal (1:1000): 1 mg (1 ml)
  5. Atropine
    1. Intravenous (0.1 mg/ml): 0.21 mg (2.1 ml)
    2. Endotracheal (0.4 mg/ml) 0.5 mg (1.3 ml)
  6. Naloxone
    1. Intravenous (0.4 mg/ml) 0.11 mg (0.28 ml)
    2. Endotracheal (0.4 mg/ml) 0.11 mg (0.28 ml)
  7. Adenosine
    1. Initial dose (6 mg/2ml): 1 mg (0.33 ml)
    2. Next dose (6 mg/2ml): 2.1 mg (0.7 ml)
  8. Amiodarone
    1. Intravenous (50 mg/ml): 50 mg (1 ml)
  9. Calcium Chloride
    1. Intravenous (100 mg/ml = 10%): 210 mg (2.1 ml)
  10. Magnesium Sulfate
    1. Intravenous (5 g/10 ml = 500 mg/ml = 4 meq Mg/ml = 50%) 525 mg (1.1 ml)
  11. Sodium Bicarbonate
    1. Intravenous (1 meq/ml = 84 mg/ml = 8.4%) 10 meq (10 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

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window