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Emergency Pediatric Dosing

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1. Dexmedetomidine as Bolus or Low-dose Infusion for the Prevention of Emergence Agitation with Sevoflurane Anesthesia in Pediatric Patients. (PubMed)

Dexmedetomidine as Bolus or Low-dose Infusion for the Prevention of Emergence Agitation with Sevoflurane Anesthesia in Pediatric Patients. This study was designed to compare the prevention of emergence agitation (EA) of sevoflurane anesthesia by an intraoperative bolus or low-dose infusion of dexmedetomidine in pediatric patients undergoing lower abdominal surgeries.Forty-eight patients, aged 2-12 years, undergoing lower abdominal surgeries with sevoflurane anesthesia were enrolled (...) in this study. Patients were randomly assigned to receive either intravenous bolus over 10 min. 0.4 μg/kg dexmedetomidine (Group I, n = 24) or low-dose infusion 0.4 μg/kg/h of dexmedetomidine (Group II, n = 24) after intubation. Heart rate and mean arterial pressure were recorded before induction, at induction and every 5 min after induction. Observational pain scores (OPS), pediatric anesthesia emergence delirium (PAED) scores, and Ramsay sedation scores (RSS) were recorded on arrival to the postanesthesia

2019 Anesthesia, essays and researches Controlled trial quality: uncertain

2. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, I

2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, I 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support (...) Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces , MA, MB, BChir, FRCA, FFICM, FRCP , FRCPCH, FRCEM, FRCPI, PhD , MD , MD, PhD , MD , MD, MME , BMedSc, MBChB , MD, MSc, FRCPC, FAHA , MD , RN, PhD, FAHA , MBChB, BSC, FERC , LVO, MBBS , MD, MPH, PhD, DMSc , MD, FAHA , MA, MEd, FRCPC , MBBS, MM, PhD , MD

2019 American Heart Association

3. CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections

CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections - CanadiEM CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections In , , by Adam Thomas April 9, 2018 This episode of CRACKCast Covers Rosen’s Chapter 167, Pediatric Upper Airway Emergencies. Stridor is a very common presentation and this episode will help out with diagnosis (...) . It is usually a disease of infants and toddlers because the lymphatic chains are prominent in the young and atrophy before puberty. Approximately 50% of pediatric cases occur in children 6 to 12 months of age, most occur before 3 years of age , and 96% of all diagnosed pediatric retropharyngeal abscesses are seen before 6 years of age. Clinical presentation: Fever Sore throat Neck stiffness or nuchal rigidity Torticollis Tismus Neck swelling Drooling Stridor, and muffled voice. **look for the child who has

2018 CandiEM

4. Assessment of Emergency Department Antibiotic Discharge Prescription Dosing Errors for Pediatric Patients in a Community Hospital Health System. (PubMed)

Assessment of Emergency Department Antibiotic Discharge Prescription Dosing Errors for Pediatric Patients in a Community Hospital Health System. We quantify and describe emergency department antibiotic discharge prescription dosing errors for pediatric patients in a community hospital health system.This was a retrospective chart review evaluating emergency department discharge prescriptions written between July 1, 2014, and June 30, 2015. Pediatric patients who received a prescription (...) for an oral antibiotic were included in error analysis if they had a weight updated in the electronic medical record during the encounter. We used a predefined threshold of +10% variance from the recommended dose to quantify error. Prescriber, environmental, and antibiotic specific data were also collected to identify variables associated with high incidence of error.Among the 1934 prescriptions included in our error analysis, we detected 776 (40%) dosing errors. Of the prescriptions reviewed, 288 (15

2018 Pediatric Emergency Care

5. Improving efficiency of pediatric emergency asthma treatment by using metered dose inhaler. (PubMed)

Improving efficiency of pediatric emergency asthma treatment by using metered dose inhaler. Evidence suggests using metered dose inhaler (MDI) to treat acute asthma in the Emergency Department reduces length of stay, though methods of implementation are lacking. We modified a treatment pathway to recommend use of MDI for mild-moderate asthma in a pediatric ED.A baseline review assessed discharged patients >2 years with an asthma diagnosis and non-emergent Emergency Severity Index triage

2018 Journal of Asthma

6. Dosing Errors Made by Paramedics During Pediatric Patient Simulations After Implementation of a State-Wide Pediatric Drug Dosing Reference. (PubMed)

Dosing Errors Made by Paramedics During Pediatric Patient Simulations After Implementation of a State-Wide Pediatric Drug Dosing Reference. Background: Drug dosing errors occur at a high rate for prehospital pediatric patients. To reduce errors, Michigan implemented a state-wide pediatric dosing reference (PDR), with doses listed in milliliters, the requirement that doses be drawn into a smaller syringe from a pre-loaded syringe using a stopcock, and dilution of certain drugs to different (...) to carry out all the steps to administer a drug dose. Two evaluators scored crew performance via direct observation and video review. An error was defined as ≥ 20% difference compared to the weight-appropriate dose. Descriptive statistics were utilized. Results: A total of 142 simulations were completed. The majority of crews were (58.3%) Emergency Medical Technician-Paramedic (EMTP)/EMTP. For the cardiac arrest scenario, 51/70 (72.9%; 95% CI: 60.9%, 82.8%) epinephrine doses were correct. There were 6

2019 Prehospital emergency care

7. Cost-effectiveness of metered-dose inhalers for asthma exacerbations in the pediatric emergency department

Cost-effectiveness of metered-dose inhalers for asthma exacerbations in the pediatric emergency department Cost-effectiveness of metered-dose inhalers for asthma exacerbations in the pediatric emergency department Cost-effectiveness of metered-dose inhalers for asthma exacerbations in the pediatric emergency department Doan Q, Shefrin A, Johnson D Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) . Concluding remarks: The methods were appropriate, and the data sources and results were clearly reported. The authors’ conclusions are valid. Funding Not stated. Bibliographic details Doan Q, Shefrin A, Johnson D. Cost-effectiveness of metered-dose inhalers for asthma exacerbations in the pediatric emergency department. Pediatrics 2011; 127(5): e1105-e1111 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Administration, Inhalation; Adolescent; Albuterol

2011 NHS Economic Evaluation Database.

8. Pediatric Weight Errors and Resultant Medication Dosing Errors in the Emergency Department. (PubMed)

Pediatric Weight Errors and Resultant Medication Dosing Errors in the Emergency Department. An accurate weight is critical for dosing medications in children. Weight errors can lead to medication-dosing errors.This study examined the frequency and consequences of weight errors occurring at 1 children's hospital and 2 general hospitals.Using an electronic medical record database, 79,000 emergency department encounters of children younger than 5 years were analyzed. Extreme weights were first (...) or weight-based medication errors. Common weight errors included the weight in pounds being substituted for the weight in kilograms and decimal placement errors.Weight errors were uncommon at the 3 emergency departments that we studied, but they led to weight-based medication-dosing errors that had the potential to cause harm.

2017 Pediatric Emergency Care

9. Comparison of Ultrasonography and Low-Dose Computed Tomography for the Diagnosis of Pediatric Urolithiasis in the Emergency Department (PubMed)

Comparison of Ultrasonography and Low-Dose Computed Tomography for the Diagnosis of Pediatric Urolithiasis in the Emergency Department This study aimed to compare ultrasonography (US) and low-dose computed tomography (LDCT) for diagnosing pediatric urolithiasis in the emergency department.This retrospective study was approved by our institutional ethics committee, and informed consent was waived. From March 2016 to March 2017, 100 consecutive patients met the selection criteria and were (...) of renal stones (p=1 for all). The diagnostic accuracy of US and LDCT was 0.68 and 1.0, respectively.Low-dose computed tomography had 1/3 SDCT radiation dose, and LDCT and SDCT accurately diagnosed pediatric urolithiasis in the emergency department. US had a lower accuracy than SDCT and LDCT for diagnosing pediatric urolithiasis in the emergency department. LDCT can be an alternative for SDCT for diagnosing pediatric urolithiasis.

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2017 The Eurasian journal of medicine

10. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio Copyright © ESPGHAN and NASPGHAN. All rights reserved. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (...) and the European Society forPediatricGastroenterology,Hepatology,andNutrition Rachel Rosen, y Yvan Vandenplas, z Maartje Singendonk, § Michael Cabana, jj Carlo DiLorenzo, Frederic Gottrand, # Sandeep Gupta, Miranda Langendam, yy Annamaria Staiano, zz Nikhil Thapar, §§ Neelesh Tipnis, and z Merit Tabbers ABSTRACT This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

11. Development and Prospective Federal State-Wide Evaluation of a Device for Height-Based Dose Recommendations in Prehospital Pediatric Emergencies: A Simple Tool to Prevent Most Severe Drug Errors. (PubMed)

Development and Prospective Federal State-Wide Evaluation of a Device for Height-Based Dose Recommendations in Prehospital Pediatric Emergencies: A Simple Tool to Prevent Most Severe Drug Errors. Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved (...) randomization due to the expected positive effect of the PaedER on outcome.Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER. Post-interventional data were collected prospectively over a six-year period in a federal state-wide open trial. The administered doses of either intravenous or intraosseous fentanyl, midazolam, ketamine or epinephrine were

2016 Prehospital emergency care

12. Emergency Pediatric Dosing

Emergency Pediatric Dosing Emergency Pediatric Dosing Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Emergency Pediatric Dosing (...) Emergency Pediatric Dosing Aka: Emergency Pediatric Dosing , Emergency Pediatric Dosing Weight Estimation , Broselow Tape , Broselow Luten Color Coding for Pediatric Weight Estimation II. Approach: Measurement with Broselow Tape Patient lies supine (not sitting) Place the red arrow indicator of the Broselow Tape to the level of the top of the patient's head Unfold the Broselow Tape so that the patient's heels are in line with a color zone Use the identified color zone in the protocol below Adjustments

2018 FP Notebook

13. Emergency Pediatric Dosing over 36 kilogram

Emergency Pediatric Dosing over 36 kilogram Emergency Pediatric Dosing over 36 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration (...) 4 Emergency Pediatric Dosing over 36 kilogram Emergency Pediatric Dosing over 36 kilogram Aka: Emergency Pediatric Dosing over 36 kilogram , Broselow Over 36 kg II. Criteria: Body habitus Age: 13 years and older Weight >36 kg III. Findings: Vital Signs (normal) : 60-120/minute : 12-18/minute Systolic : 100-130 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Pretreatment 1.5 mg/kg 3 mcg/kg Induction (Sedation) 0.3 mg/kg (most common induction agent) 1.5 mg/kg

2018 FP Notebook

14. Emergency Pediatric Dosing 30-36 kilogram

Emergency Pediatric Dosing 30-36 kilogram Emergency Pediatric Dosing 30-36 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Emergency Pediatric Dosing 30-36 kilogram Emergency Pediatric Dosing 30-36 kilogram Aka: Emergency Pediatric Dosing 30-36 kilogram , Broselow Green II. Criteria: Body habitus Age: 10-12 years Length: 137-150 cm Weight: 30-36 kg (mean 33 kg) III. Findings: Vital Signs (normal) : 60-120/minute : 12-25/minute Systolic : 95-120 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Induction (Sedation) 10 mg 66 mg 100 mg Paralytic 66 mg 33 mg 3.3 mg Sedation Maintenance 1.6 mg

2018 FP Notebook

15. Emergency Pediatric Dosing 24-28 kilogram

Emergency Pediatric Dosing 24-28 kilogram Emergency Pediatric Dosing 24-28 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Emergency Pediatric Dosing 24-28 kilogram Emergency Pediatric Dosing 24-28 kilogram Aka: Emergency Pediatric Dosing 24-28 kilogram , Broselow Orange II. Criteria: Body habitus Age: 7-9 years Length: 122-137 cm Weight: 24-28 kg (mean 27 kg) III. Findings: Vital Signs (normal) : 60-120/minute : 12-25/minute Systolic : 90-115 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Induction (Sedation) 8 mg 53 mg 80 mg Paralytic 53 mg 27 mg 2.7 mg Sedation Maintenance 1.3 mg

2018 FP Notebook

16. Emergency Pediatric Dosing 19-22 kilogram

Emergency Pediatric Dosing 19-22 kilogram Emergency Pediatric Dosing 19-22 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Emergency Pediatric Dosing 19-22 kilogram Emergency Pediatric Dosing 19-22 kilogram Aka: Emergency Pediatric Dosing 19-22 kilogram , Broselow Blue II. Criteria: Body habitus Age: 5-6 years Length: 110 to 122 cm Weight: 19-22 kg (mean 21 kg) III. Findings: Vital Signs (normal) : 65-135/minute : 20-30/minute Systolic : 80-110 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Induction (Sedation) 6.3 mg 42 mg 63 mg Paralytic 40 mg 21 mg 2.1 mg Sedation Maintenance 1 mg

2018 FP Notebook

17. Emergency Pediatric Dosing 15-18 kilogram

Emergency Pediatric Dosing 15-18 kilogram Emergency Pediatric Dosing 15-18 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Emergency Pediatric Dosing 15-18 kilogram Emergency Pediatric Dosing 15-18 kilogram Aka: Emergency Pediatric Dosing 15-18 kilogram , Broselow White II. Criteria: Body habitus Age: 3-4 years Length: 97.5 to 110 cm Weight: 15-18 kg (mean 16.5 kg) III. Findings: Vital Signs (normal) : 75-135/minute : 20-30/minute Systolic : 80-110 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Induction (Sedation) 5 mg 33 mg 50 mg Paralytic 33 mg 17 mg 1.7 mg Sedation Maintenance 0.8

2018 FP Notebook

18. Emergency Pediatric Dosing 12-14 kilogram

Emergency Pediatric Dosing 12-14 kilogram Emergency Pediatric Dosing 12-14 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Emergency Pediatric Dosing 12-14 kilogram Emergency Pediatric Dosing 12-14 kilogram Aka: Emergency Pediatric Dosing 12-14 kilogram , Broselow Yellow II. Criteria: Body habitus Age: 18-36 months Length: 84.5 to 97.5 cm Weight: 12-14 kg (mean 13 kg) III. Findings: Vital Signs (normal) : 90-150/minute : 20-30/minute Systolic : 70-110 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Induction (Sedation) 4 mg 26 mg 40 mg Paralytic 26 mg 13 mg 1.3 mg Sedation Maintenance

2018 FP Notebook

19. Emergency Pediatric Dosing 10-11 kilogram

Emergency Pediatric Dosing 10-11 kilogram Emergency Pediatric Dosing 10-11 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Emergency Pediatric Dosing 10-11 kilogram Emergency Pediatric Dosing 10-11 kilogram Aka: Emergency Pediatric Dosing 10-11 kilogram , Broselow Purple II. Criteria: Body habitus Age: 11-18 months Length: 74 to 84.5 cm Weight: 10-11 kg (mean 10.5 kg) III. Findings: Vital Signs (normal) : 110-170/minute : 20-30/minute Systolic : 70-110 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Induction (Sedation) 3.2 mg 20 mg 32 mg Paralytic 20 mg 10 mg 1 mg Sedation Maintenance

2018 FP Notebook

20. Emergency Pediatric Dosing 8-9 kilogram

Emergency Pediatric Dosing 8-9 kilogram Emergency Pediatric Dosing 8-9 kilogram Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Emergency Pediatric Dosing 8-9 kilogram Emergency Pediatric Dosing 8-9 kilogram Aka: Emergency Pediatric Dosing 8-9 kilogram , Broselow Red II. Criteria: Body habitus Age: 7-10 months Length: 66.5 to 74 cm Weight: 8-9 kg (mean 8.5 kg) III. Findings: Vital Signs (normal) : 110-185/minute : 25-40/minute Systolic : 65-105 mmHg IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation Pretreatment 0.17 mg Induction (Sedation) 2.5 mg 17 mg 25 mg Paralytic 17 mg 9 mg 0.9 mg Sedation

2018 FP Notebook

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