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PICU POCKET CARD
ETT size= (Age in years+16)/4ETT depth from lip/teeth=3xETT
size! inf"sions# mg dr"g/1$$ml %"id =6 x desired
dose(m&g/'g/min) x
eight('g)esired rate (m*/hr)VASOPRESSORS:e
di&ation
ose(m&g/'g/min)
!inf"sionrate
opamine ,-.$ 1ml/hro"tamine
,-.$ 1ml/hr
Adrenaline(0arm
sho&')
$1-1 1ml/hr=$1m&g/
'g/min2or-adrenaline(oldsho&')
$$,-. 1ml/hr=$1m&g/'g/min
ilrinone ,$-,mg/'gloadingdose$.,-1mg/'g/min
SEDATION by infusion:idazolam 1-3 m&g/'g/min5entanyl 1-,
m&g/'g/hr(1$$"g/ml ine&tion)7ropofol 1-. mg/'g/hrorphine
$1-$. mg/'g/hr after a ol"s of $1 mg/'g
(1$mg/ml ine&tion)Atra&"ri"m $, mg/'g $3-$,
mg/'g/min
FORMULAE:1 89A(m.)=
height(cm )weight(kg )3600
or weight height60
. :5; = ' < height(&m)/9&reat(mg/d*) =
xml/min/13m.
a = $33 in *80> t?1'g
$4, in term A:A ? 1year
& $,, in
&hildren/adoles&entfemalesd $$ in adoles&ent
males3 7oderal index = eight/length3
< 1$$4 :; = @ of dextrose < inf"sion
rate(ml/'g/day) /144, 8i&ar &orre&tion#
a 2eonate=$6 xeight(98E-)
2on-neonate=$3 x
eight(98E-)& :iBe half dose stat and
remaining in diBideddoses in !5
d 9tat dose as 1-. mEC/'g
6 9odi"m &orre&tion = $6 max ,mg for
?, yrs> 1$mg for L,yrs. *F;AGE7A# $$,-$1
mg/'g/dose > max 4 mg3 7KE2F8A;8TF2E# *oading
1,-.$ mg/'g at 1mg/'g/min>&an giBe ,mg/'g till max
3$mg/'g aintenan&e 3-,mg/'g/d C1.h or K9 F
4 7KE2JTF2# loading dose1,-.$mg/'g/d at
1mg/'g/minmaintianen&e dose ,Nmg/'g/d C-1.h
, !A*7;FATE# loading .$mg/'g ,-1$ mg/'g/dose ChSEDATION
FORPROCEDURES:
1 AGF*A# $. mg/'g/dose>max 6mg> in&rements of .,@
ofinitial dose . 5F;T02# 1 mg/'g/dose 3 7KE2A;:A2# 1 mg/'g/dose
OTHERS:1 ;A2TA# 1 mg/'g/dose K !>C1.K 7F
. *A9 ranging "p to 1 se&ondin older 'ids3 ;ate (!)- age
appropriate 3$(infants) don to 1,( ad"lt sized
patients) to start4 Tidal Bol"me (!t) - 1$ml/'gro"nding don then
loo' at &hestrise> listen for reath so"nds and&he&'
7ea' nspiratory 7ress"re (77), e&rease !t 5 exam
reBealsex&essiBe &hest rise> large air entryand higher
than expe&ted 77s (?3$-3, &m K.$) EleBated 77s may
res"ltfrom ; main stem ET t"epla&ement> m"&o"s
pl"gging>ex&essiBe !t or poor l"ng
&omplian&e> ie 1O p"lmonarydisease 9trongly
&onsider sit&hingto press"re &ontrol style reath
forseBere l"ng disease6 n&rease !t 5 exam reBeals poor&hest
rise> minimal air entry andloer than expe&ted 77s (?1,
&mK.$) 8e aare that ad"lt sizeBentilator &ir&"its may
gole largeamo"nts of Bol"me ea&h reath (.-3&&/ eBery
&m K.F press"re diPeren&eeteen 77 and 7EE7) f this
o&&"rsin&rease !t or &hange to a
press"re&ontrol style reath 7EE7 - 4&m> higher if
5;&ompromised y atele&tasis>adominal distension or
seBere l"ngdisease n&rease in .&m K.F
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aliC"ots !ol"me re&r"itment ith7EE7 ta'es ho"rs "t &an e
lost inmin"tes 7ress"re 9"pport (79)- (faBailale) for spontaneo"s
reathing
patients 79 starts at 1$ &m K.FI A8: to a&&"rately
a&&essBentilation stat"s1$ andimproBes oxygenation for any
giBen!t 9trongly &onsider press"reBentilation (if aBailale) for
large airlea's d"e to small ET t"e size>inePe&tiBe
Bentilation .O ad"lt Bent&ir&"it on small
infant/&hild> or poorl"ng &omplian&e3 9et 7ress"re
&ontrol to giBeePe&tiBe &hest rise and aCed"ate
airentry Expe&t 77s 1-.. &m K.F inpatients ith healthy
l"ngs> .3-.&m K.F for moderate l"ng disease>
.-3, &m K.F in more seBeredisease4 Fn&e 7 is
estalished> loo' atma&hine meas"red inspiratory
andexpiratory Bol"mes as an estimate of
patients l"ng &omplian&e !ol"messho"ld e ?1$ml/'g to
aBoidoBerstret&h
Si')% P#ob%' so%*in&:0hen aBentilated patient
a&"telydeteriorates donQt e aRD islodged ET T"e- &he&'
for eC"alreath so"nds> EtF. S>Ostr"&ted M "&o"s
pl"g> s"&tionPne"mothorax- &he&' for eC"alreath
so"nds> needle &ompression
Bs hand ag> &onDrm 1$$@ F. is%oing
S"#a"&is fo# 'o# Co')%+)#ob%'s:Kypoxemia# goal is to ean 5F.
?,$@1 inimize airlea' y pla&ing largerEt t"e> y
repositioning head or&hanging to press"re mode. n&rease
7EE7 in .&m K.Fin&rements to in&rease
f"n&tionalresid"al &apa&ity (Aerated l"ngBol"me)
onsider paralyti&s for 7EE7L 1$
3 n&rease time to in&rease eanAiray press"re4
n&rease ;ate espe&ially if 7F. iseleBated as ell and there
is need toin&rease min"te Bentilation
, hanging to 7ress"re &ontrol illres"lt in improBed
oxygenation forthe same Bol"me deliBered6 Fn&e the appropriate
!t isestalished> re&ommend against&hanging Bol"mes n A;9
Bentilatorind"&ed l"ng in"ry is asso&iated ithTB L -1$
ml/'gHi&$ Pa, P#ssu#s:(L3, &mK.For platea" press"re L 3$
&m K.F)1 9"&tion Et t"e. he&' t"e position ith
