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Emergency Pediatric Dosing 12-14 kilogram


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101. Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Ischemic Heart Disease

mSv. CAD imaging modalities are associated with average exposures of ≈11 mSv for rest-stress myocardial perfusion technetium Tc-99m SPECT and ≈10 mSv for CCTA. Low-dose procedures should be applied preferentially, whenever possible. Dose-reduction techniques for CCTA result in substantially lower doses while maintaining image quality. A prospectively triggered scan has a typical effective dose of 3 to 5 mSv, whereas a retrospectively gated scan has a typical effective dose from 12 to 25 mSv (...) equivalents, or METs]) at which ischemia may be detected using such tools as the validated Duke Activity Status Index (DASI). The DASI is a self-administered, 12-question form designed to provide an estimate of physical exercise capacity (in milliliters per kilogram per minute; dividing by 3.5 can provide estimated METs). Routine ADL require ≈4 to 5 METs of work; women who indicate difficulties in performing daily activities should be considered to have functional limitations. An inability to achieve

2014 American Heart Association

102. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

of Evidence B ). Class changed from IIa to I Pregnancy In the presence of a high-risk condition that would require anticoagulation outside of pregnancy, the following options are reasonable:a. LMWH twice daily throughout pregnancy, with dose adjusted to achieve the LMWH manufacturer’s recommended peak anti-Xa level 4 hours after injection, orb. Adjusted-dose UFH throughout pregnancy, administered subcutaneously every 12 hours in doses adjusted to keep the midinterval aPTT at least twice control (...) among survivors of ischemic stroke or TIA. The current average annual rate of future stroke (≈3%–4%) represents a historical low that is the result of important discoveries in prevention science. These include antiplatelet therapy and effective strategies for treatment of hypertension, atrial fibrillation (AF), arterial obstruction, and hyperlipidemia. Since the first of these therapies emerged in 1970, when results of the Veterans Administration Cooperative Study Group trial of hypertension therapy

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2014 American Heart Association

103. Guidelines for the Primary Prevention of Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

% of strokes are first events. 1 Fortunately, there are enormous opportunities for preventing stroke. An international case-control study of 6000 individuals found that 10 potentially modifiable risk factors explained 90% of the risk of stroke. 8 As detailed in the sections that follow, stroke-prone individuals can readily be identified and targeted for effective interventions. This guideline summarizes the evidence on established and emerging stroke risk factors and represents an update of the last (...) of the recommendations. As with all therapeutic recommendations, patient preferences must be considered. Risk factors, which directly increase disease prob- ability and if absent or removed reduce disease probability, or risk markers, which are attributes or exposures associated with increased probability of disease but are not necessarily causal 12 of a first stroke, were classified according to their potential for modification. 7 Although this distinction is some- what subjective, risk factors considered both well

2014 American Heart Association

104. Diagnosis and management of glycogen storage disease type I: a practice guideline of the American College of Medical Genetics and Genomics

- tions, or enterocolitis. ° The lowest effective G-CSF dose should be used to avoid worsening of splenomegaly, hypersplenism, hepatomegaly, and bone pain. G-CSF should be administered subcutane- ously starting at 0.5–1.0 µg per kilogram per day given daily or every other day. The G-CSF dose should be increased step- wise at approximately 2-week intervals until the target ANC of more than 500 to up to 1.0?×?10 9 /l is reached. This dose then should be maintained, adjusting for subsequent increas- es (...) in patients with neutropenia. When the intercurrent illness causes decreased dietary intake, the patient’s specialist should be contacted. In such cases more frequent monitoring of BG and additional doses of CS may be indicated. Patients who cannot main- tain normal dietary intake/CS treatment or who have eme- sis should proceed to the nearest emergency department for evaluation and i.v. glucose treatment. The patient’s specialist should be made aware and, ideally, should contact the emer - gency

2014 American College of Medical Genetics and Genomics

105. Royal Flying Doctor Service Western Operations Clinical manual part 1.Clinical guidelines

1 12.2 Acute Asthma 3 12.3 Bronchiolitis 5 13 TOXICOLOGY 1 13.1 Snakebite 1 13.2 Red-back Spider Bite (RBSB) 4 13.3 Irukandji Syndrome 6 13.4 An Approach To Poisoning 8 13.5 Paraquat Poisoning 9 13.6 Serotonin Syndrome 11 13.7 Cyanide Poisoning 12 14 TRAUMA 1 14.1 Burns 1 14.2 Hydrofluoric Acid Burns 5 14.3 Identification and Management of Pelvic Fractures 6 14.4 Crush Syndrome 8 14.5 Fractured Neck of Femur 9 14.6 Screening Adults With Suspected Cervical Spine Fractures 10 14.7 Acute Spinal (...) This is a controlled document. Ensure you are using the latest version. Filename: G:\HEALTH\MEDICAL\CLINICAL MANUAL\PART 1 – CLINICAL GUIDELINES – JANUARY 2013 Savedate: 20/12/2012 16:47 RFDS Western Operations Version 6.0 Clinical Manual Issue Date: January 2013 Part 1 - Clinical Guidelines Table of Contents Part 1 - Clinical Guidelines Table of Contents 1 LIFE SUPPORT 1 1.1 Basic Life Support Flow Chart 1 1.2 Newborn Life Support Flow Chart 2 1.3 Advanced Life Support (Adult) 3 1.4 Advance Life Support

2014 Clinical Practice Guidelines Portal

106. Acute croup in children

for the management of croup in children. 2007. 8. Russell KF, Liang O’Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup, Cochrane Database Systematic Rev 2011;(1):CD001955 9. Woods C. Approach to the management of croup. Up To Date 2016 10. AMH Children’s Dosing Companion July 2017. 11. Ortiz-Alvarez O; Canadian Pediatric Society. Acute management of croup in the emergency department. May 2017 12. Russell KF, Liang Y, O’ Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup; Cochrane Database (...) systematic review 2011 13. Oral dexamethasone in the treatment of croup: 0.15 mg/kg versus 0.3 mg/kg versus 0.6 mg/kg. Geelhoed GC, Macdonald WB Pediatr Pulmonol. 1995 Dec; 20(6):362-8. 14. A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup. Chub-Uppakarn S, Sangsupawanich P Int J Pediatr Otorhinolaryngol. 2007 Mar; 71(3):473-7 15. Alshehri M, Almegamsi T, Hammdi A. Efficacy of a small dose of oral dexamethasone in croup. Biomed Res (Aligarh

2014 Clinical Practice Guidelines Portal

107. Perinatal care at the threshold of viability

age achieved, (e.g. only if gestation reaches 24 weeks) then administer corticosteroids prior to the specified gestation (i.e. don’t wait until 24 weeks+0 days) • Inform the family that administration does not oblige or necessarily equate to a final decision for life sustaining interventions • Where corticosteroids are indicated, administer: o Betamethasone 11.4 mg IM o 2 nd dose: Give 24 hours after initial dose, however if birth likely within 24 hours, consider repeat dose at 12 hours o Consider (...) administration of additional dose if more than 7 days since initial dose 46 *Refer to Australian pharmacopoeia for complete drug information Queensland Clinical Guideline: Perinatal care at the threshold of viability Refer to online version, destroy printed copies after use Page 20 of 35 5.3 Cardiotocograph monitoring Table 14. Cardiotocograph monitoring Aspect Considerations Context • Physiological control of FHR and resultant cardiotocograph (CTG) trace interpretation differs in the preterm compared

2014 Clinical Practice Guidelines Portal

108. Heart Disease and Stroke Statistics?2016 Update

. High Blood Pressure e135 10. Diabetes Mellitus e148 11. Metabolic Syndrome e162 12. Chronic Kidney Disease e178 Cardiovascular Conditions/Diseases 13. Total Cardiovascular Diseases e184 14. Stroke (Cerebrovascular Disease) e204 15. Congenital Cardiovascular Defects and Kawasaki Disease e235 16. Disorders of Heart Rhythm e247 17. Sudden Cardiac Arrest e268 18. Subclinical Atherosclerosis e279 19. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris e292 20. Cardiomyopathy and Heart (...) behaviors and factors currently varies from about 1.5% for the healthy diet pattern to up to 78% for the smoking metric (never having smoked or being a former smoker who has quit for >12 months). Fewer children over time are meeting the ideal body mass index metric, whereas more are meeting the ideal smoking and total cholesterol metrics. Other metrics do not show consistent trends over time in children. More adults over time are meeting the smoking metric, whereas fewer are meeting the body mass index

2014 American Heart Association

109. Primary Prevention of Childhood Obesity (Second Edition)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Interpretation of Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 RNAO Expert Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 RNAO Best Practice Guideline Program Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 (...) interventions occur in the earliest stages of a child’s growth and development (birth to 12 years of age). In contrast, there was less literature focused on adolescents, and interventions with adolescents reported less-successful outcomes. The expert panel identifies adolescence as a period of time during which healthy behaviours learned as a child may be sustained for the primary prevention of obesity. Moreover, specific interventions directed toward childhood health differ from the peer-based approach

2014 Registered Nurses' Association of Ontario

110. Analgesia: use of patient/proxy patient controlled analgesia in palliative care

: To ensure that there is no loss of analgesia during conversion. Rationale 11: To ensure that there is an adequate supply for the patient in the place of care. Rationale 12: To prevent siphonage ( ). Rationale 13: To prevent siphonage and reflux. Rationale 14: Patient safety and audit trail of equipment used. Rationale 15: All PCA/PPCA pumps should be deep cleaned and serviced at least once a year. Orange stickers indicate when this service is due. Rationale 16: To adhere to hospital drug policy (...) -limiting conditions: The perspectives of families and key health professionals. Research report for Cancer Care Research Centre. Sterling, University of Sterling Melzer-Lange MD, Walsh-Kelly CM, Lea G, Hillery CA, Scott JP (2004). . Pediatric Emergency Care 20 (1): 2-4. [Last accessed 28.07.2017] Mherekumombe MF, Collins JJ (2015). Journal of Pain and Symptom Management 49 (5): 923-7. [Last accessed 28.07.2017] Peters J, Campbell F, Middleton J, Keen K, Howard R (2013). The incidence of urinary

2014 Publication 1593

111. Autologous Gene Therapy for Artemis-Deficient SCID

Frame: 2 years ] Patient survival status and (if applicable) cause of death will be recorded to assess overall survival. Secondary Outcome Measures : Dose of AProArt transduced cells [ Time Frame: 1 month ] Number of AProArt-transduced CD34 cells infused per kg of body weight will be calculated, with a target of at least 2x10e6 transduced cells and up to 15x10e6 transduced cells per kilogram. Incidence of treatment emergent Adverse Events related to busulfan administration [ Time Frame: 42 days (...) with a self-inactivating lentiviral vector that contains a normal copy of the DCLRE1C gene. Prior to the infusion they will receive sub-ablative, dose-targeted busulfan conditioning. The study will investigate if the procedure is safe, whether it can be done according to the methods described in the protocol, and whether the procedure will provide a normal immune system for the patient. A total of 15 patients will be enrolled at the University of California San Francisco in this single-site trial

2018 Clinical Trials

112. Hospital mergers and the risk to patient safety

in a hospital that was seeing more pediatric patients as a result of a new affiliation inadvertently gave a child double the dose of an anti-seizure medicine. That happened because medication doses for children are based on their weight in kilograms and this emergency department, not used to treating children, didn’t have a reliable system for converting pounds to kilograms. An emergency medicine physician was assigned to cover a 24-hour urgent care center with just 30 minutes of orientation. With only (...) Hospital mergers and the risk to patient safety Hospital mergers and the risk to patient safety Hospital mergers and the risk to patient safety | | August 14, 2018 85 Shares “Better patient care” is the reason hospital and health systems usually give when they merge or acquire one another. Our research suggests that mergers and affiliations might, paradoxically, increase the risk of harm to patients in the short run. Improving the safety of patient care is possible during mergers

2018 KevinMD blog

113. Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®): Health Professional Version

Cancer Information Summaries [Internet]. Bethesda (MD): ; 2002-. Search term Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®) Health Professional Version PDQ Pediatric Treatment Editorial Board . Published online: October 29, 2018. This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of Wilms tumor and other childhood kidney tumors. It is intended as a resource to inform and assist clinicians (...) who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions. This summary is reviewed regularly and updated as necessary by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH). General Information About Childhood Kidney

2016 PDQ - NCI's Comprehensive Cancer Database

114. Dexmedetomidine for Adult Patients Undergoing Surgery: A Review of Clinical Efficacy and Safety

-morbidities or risk factors. The RCTs included patients with a low risk of perioperative mortality as measured by the American Society of Anesthesiologists scoring system (ASA score I to III). Dexmedetomidine for Adult Patients Undergoing Surgery 4 Patients underwent various types of surgeries including minor surgical procedures, 8 dental surgery, 10 abdominal surgery, 9,18 lower extremity surgery, 11 upper limb surgery, 12 cardiac surgery, 13,19 brain surgery, 14-16 tympanoplasty and septoplasty, 20 (...) or 0.06 mg/kg doses or Saline (equivalent volume) Bradycardia (HR 30% decrease in mean BP compared with preoperative value) Esmaoglu 2010 12 Turkey Patients undergoing forearm and hand surgery (mean age 36 years) Axillary block ASA grade I-II N=60 DEX 100 µg (1mL) + 40mL Levobupivacaine† 0.5%; 10mL of the solution injected as an axillary brachial plexus block in 4 nerves Saline (equivalent volume) + Levobupivacaine Bradycardia Hypotension Menda 2010 13 Turkey Patients undergoing coronary artery bypass

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

115. Safety, Tolerability and Pharmacokinetics of SHP465 in Children Aged 4 to 5 Years With Attention-Deficit/Hyperactivity Disorder (ADHD)

: NCT03327402 Recruitment Status : Completed First Posted : October 31, 2017 Last Update Posted : January 3, 2019 Sponsor: Shire Information provided by (Responsible Party): Shire Study Details Study Description Go to Brief Summary: The purpose of this study is to evaluate the pharmacokinetics (PK), safety, and tolerability of SHP465 in children aged 4 to 5 years with ADHD after multiple daily doses of 6.25 milligram (mg) SHP465 Condition or disease Intervention/treatment Phase Attention Deficit (...) Hyperactivity Disorder (ADHD) Drug: SHP465 Phase 1 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 24 participants Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: A Phase 1 Open-label Study of the Safety, Tolerability, and Pharmacokinetics of d- and l-Amphetamine After Multiple Daily Doses of SHP465 6.25 mg Administered in Children Aged 4 to 5 Years With Attention-Deficit

2017 Clinical Trials

116. A Study to Evaluate the Antiviral Activity, Clinical Outcomes, Safety, Tolerability, and Pharmacokinetics of Orally Administered Lumicitabine (JNJ-64041575) Regimens in Hospitalized Infants and Children Aged 28 Days to 36 Months Infected With Respiratory

14, 2018 Sponsor: Janssen Research & Development, LLC Information provided by (Responsible Party): Janssen Research & Development, LLC Study Details Study Description Go to Brief Summary: The purpose of this study is to determine in hospitalized infants and children who are infected with respiratory syncytial virus (RSV) the dose-response relationship of multiple regimens of lumicitabine on antiviral activity based on nasal RSV shedding using quantitative real-time reverse transcriptase (...) Aged 28 Days to 36 Months Infected With Respiratory Syncytial Virus Actual Study Start Date : November 24, 2017 Actual Primary Completion Date : March 23, 2018 Actual Study Completion Date : March 23, 2018 Arms and Interventions Go to Arm Intervention/treatment Experimental: Regimen A (Low-Dose Lumicitabine) Participants will receive a single 40 milligram per kilogram (mg/kg) loading dose (LD) (Dose 1) followed by nine 20 mg/kg maintenance doses (MDs) (Doses 2 to 10) of lumicitabine twice daily up

2017 Clinical Trials

117. Open-label Study of Midazolam Hydrochloride Oromucosal Solution (MHOS/SHP615) in Children With Status Epilepticus (Convulsive) in a Healthcare Setting in Japan

the Efficacy, Safety, and Pharmacokinetics of Buccally Administered MHOS/SHP615 in Pediatric Patients With Status Epilepticus (Convulsive) in the Hospital or Emergency Room Actual Study Start Date : November 27, 2017 Estimated Primary Completion Date : November 27, 2019 Estimated Study Completion Date : November 27, 2019 Resource links provided by the National Library of Medicine related topics: available for: resources: Arms and Interventions Go to Arm Intervention/treatment Experimental: SHP615 (...) Participants will receive a single age-specific dose (approximately 0.25 to 0.5 milligram per kilogram [mg/kg] as midazolam) of SHP615 oromucosal solution through buccal route upon onset of seizures. Drug: SHP615 SHP615 oromucosal solution will be administered as a single age-specific dose (2.5, 5, 7.5 and 10 mg). Other Names: Midazolam hydrochloride oromucosal solution MHOS Outcome Measures Go to Primary Outcome Measures : Percentage of Participants With Therapeutic Success [ Time Frame: From start

2017 Clinical Trials

118. Benepali - etanercept

28 2.4.1. Introduction 28 2.4.2. Pharmacokinetics 29 2.4.3. Pharmacodynamics 34 2.4.4. Discussion on clinical pharmacology 34 2.4.5. Conclusions on clinical pharmacology 35 2.5. Clinical efficacy 35 2.5.1. Dose response studies 35 2.5.2. Main study 35 2.5.3. Discussion on clinical efficacy 51 2.5.4. Conclusions on the clinical efficacy 52 2.6. Clinical safety 53 2.6.1. Discussion on clinical safety 59 2.6.2. Conclusions on the clinical safety 61 2.7. Risk Management Plan 61 2.8. Pharmacovigilance (...) Analysis of covariance AS Ankylosing spondylitis AUC Area under the concentration-time curve AUC t Area under the concentration-time curve over the dosing interval AZA Azathioprine biw Twice a week BLA Biologic License Application BMWP Biosimilar Medicinal Products Working Party bw Body weight CDAI Clinical disease activity index CDC Complement-dependent cytotoxicity cfu Colony forming unit CHMP Committee for Medicinal Products for Human Use CI Confidence Interval CL Total body clearance C max Maximum

2016 European Medicines Agency - EPARs

119. Sialanar (glycopyrronium) - for treating severe drooling of saliva in children and adolescents (aged 3 years and above) with conditions affecting the nervous system, such as cerebral palsy, epilepsy and neurodegenerative diseases

IPC in-process control IR Infrared i.v. intravenous(ly) kg kilogram(s) ?z terminal elimination rate constant L litre(s) LD 50 lethal dose 50% LDPE low density polyethylene LLOQ Lower Limit of Quantification LoA Letter of Access LOD loss on drying LoD limit of detection LoQ limit of quantitation M muscarinic (receptor) MA Marketing Authorisation MAA Marketing Authorisation Application MAH Marketing Authorisation Holder mBMRS Modified Behavioural and Medical Rating Scale mg milligram(s) MHRA (...) , PC, PG OL, SG OL, SG Rand., DB, PC, CO OS TID (1mg/5mL ) OS TID (1mg/5mL ) Capsules (0.6 mg), TID Formulatio n not stated, OD Formulatio n not stated, 1-5 times/d OS TID (0.2 mg/mL) Efficacy/Safet y Safety/Efficac y Efficacy/dose - ranging Efficacy (descriptive) Efficacy (descriptive) Efficacy/Safet y TD 20, PC 18/ 18, 16 137/103 39/27 24/22 40/38 23/23 8w 24w 1 8w (1w BL, 8w TD/PC, 1w WO, 8w PC/TD) 5w-28m (flexible? ) 8m-4y (flexible) 4w (1w each BL, TD/PC, WO, PC/TD) 22/14; TD 10.2y, PC 8.7y 77

2016 European Medicines Agency - EPARs

120. Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery

be expected to be quite small with single-dose antibiotic prophylaxis. Although the use of fluoroquinolones may be necessary for surgical antibiotic prophylaxis in some children, they are not drugs of first choice in the pediatric population due to an increased incidence of adverse events as compared with controls in some clinical trials. k Ceftriaxone use should be limited to patients requiring antimicrobial treatment for acute cholecystitis or acute biliary tract infections which may not be determined (...) surgeries. Patients undergoing lung transplantation for cystic fibrosis should receive 7–14 days of treatment with antimicrobials selected according to pretransplantation culture and susceptibility results. This treatment may include additional antibacterial or antifungal agents. t The prophylactic regimen may need to be modified to provide coverage against any potential pathogens, including vancomycin-resistant enterococci, isolated from the recipient before transplantation. Table 1. Recommended Doses

Full Text available with Trip Pro

2013 Infectious Diseases Society of America

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