Emergency Medicine Book

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Emergency Pediatric Dosing 30-36 kilogram

Aka: Emergency Pediatric Dosing 30-36 kilogram, Broselow Green
  1. See Also
    1. Emergency Pediatric Dosing (Broselow Tape)
    2. Advanced Airway
    3. Adult Resuscitation
    4. Pediatric Resuscitation
    5. Newborn Resuscitation
    6. Obstetrical Resuscitation
  2. Criteria: Body habitus
    1. Age: 10-12 years
    2. Length: 137-150 cm
    3. Weight: 30-36 kg (mean 33 kg)
  3. Findings: Vital Signs (normal)
    1. Heart Rate: 60-120/minute
    2. Respiratory Rate: 12-25/minute
    3. Systolic Blood Pressure: 95-120 mmHg
  4. 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
  5. Protocol: Miscellaneous Equipment
    1. Urinary Catheter: 12 F
    2. Nasogastric Tube: 18 F
    3. Chest Tube: 32-40 F
  6. Protocol: Fluids
    1. IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 640-740 ml
    2. IV Fluid Crystalloid Maintenance: 74-78 ml/h
  7. 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)
  8. 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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