Question | Answer |
Oral airway sizes: | Preterm –000,00
Neo <3months-0
3-12 months-1
1-5yrs - 2
> 5yrs - 3 |
ETT sizes for premies: | Less than 2 gm - 2.5
Over 2 gm - 3.0 |
ETT sizes for neonates: | 3.0-3.5 |
ETT size for 0-6 months: | 3.5 |
ETT size for 6-12 months: | 4.0 |
ETT sizes for 12-18 months: | 4.0-4.5 |
ETT size for 2 yr: | 4.5 |
ETT sizes for 2-3 yrs: | 4.5-5.0 |
ETT size for 4 yr olds and over: | Age + 16 / 4
OR
Kg + 35 / 10 |
Depth of insertion of ETT for children based on weight up to 4 kg: | 1 kg - 7 cm
2 kg - 8 cm
3 kg - 9 cm
4 kg - 10 cm |
For a child from 4 kg up to 1 yr ETT should be how deep? | 10 cm |
Depth of insertion of ETT based on age greater than one yr? | Age / 2 + 12 |
Depth of insertion of ETT based on internal diameter of ETT? | Internal diameter X 3 |
Where do you want your pediatric ETT to leak? | 20-25 cm H2O |
You should change to a smaller ETT when it leaks above what number? | 30 cm H2O |
Leaving in an ETT that didn't leak until over 30 cm H2O can cause what? | Post extubation croup. |
Change to a larger ETT when you have a leak at less than what number? | 15 cm H2O |
Cuffed tubes are rarely needed at less than what age? | 8-10. |
When using cuffed tube, how does your size determination change? | You reduce your size by 0.5 |
What Miller sizes for what ages? | Miller 0 - preterm, neonate
Miller 1 - neonate-age2
Miller 2 - 3 and older |
LMA sizes for what kilograms? | 1 - less than 5 kg
1.5 - 5-10
2 - 6.5-25
2.5 - 20-30
3 - 25-small adult
4 - large adult |
Reservoir bag sizes for what ages? | Newborn - 0.5L
1-3 yrs - 1L
3-5 yrs - 2L
Over 5 - 3L |
IV catheter sizes for what ages? | 24 g neonates, 22 g 1-5 yrs, 20 g over 5. |
Size of infusion bag should not exceed: | Patient's estimated fluid deficit. |
Microdrip set with volume limited device is mandatory for what ages? | Under 10. |
What's an ideal pediatric anesthesia breathing system? | Low dead space
Low resistance
Lightweight and compact
Low compression volume
Easily humidified
Easily scavenged
Suitable for both controlled ans spontaneous ventilation
Economy of fresh gas flow |
What's the most commonly used breathing system in infants? | Mapleson D. |
Bain circuit is: | A Mapleson D with fresh gas flow tubing inside corrugated breathing tube. |
For traditional mask induction, what percentage of gases? | 30% O2, 70% N2O. |
For single breath induction, what percentage Halothane or Sevoflurane? | 5% or 8 %. |
What nerve stimulates laryngospasm (sensory)? | Superior laryngeal nerve. |
Risk factors for laryngospasm? | AGE
EXTUBATION
AIRWAY
URI
LIGHT ANESTHESIA |
How can you tell if laryngospasm is partial or complete? | Presence of sound:
Yes - incomplete airway obstruction
No - laryngospasm! |
Preventative measures against laryngospasm: | Extubate in stage 3 or 1
Stretch the larynx with jaw thrust
Suction while deep |
Ketamine pediatric induction dose: | 2 mg/kg IV - 4-8 mg/kg IM |
Diprivan pediatric induction dose: | 2.5 - 3.5 mg/kg |
Intubating doses of sux: | 2mg/kg infants |
What's the most commonly used breathing system in infants? | Mapleson D. |
Bain circuit is: | A Mapleson D with fresh gas flow tubing inside corrugated breathing tube. |
For traditional mask induction, what percentage of gases? | 30% O2, 70% N2O. |
For single breath induction, what percentage Halothane or Sevoflurane? | 5% or 8 %. |
What nerve stimulates laryngospasm (sensory)? | Superior laryngeal nerve. |
Risk factors for laryngospasm? | AGE
EXTUBATION
AIRWAY
URI
LIGHT ANESTHESIA |
How can you tell if laryngospasm is partial or complete? | Presence of sound:
Yes - incomplete airway obstruction
No - laryngospasm! |
Preventative measures against laryngospasm: | Extubate in stage 3 or 1
Stretch the larynx with jaw thrust
Suction while deep |
Ketamine pediatric induction dose: | 2 mg/kg IV - 4-8 mg/kg IM |
Diprivan pediatric induction dose: | 2.5 - 3.5 mg/kg |
Intubating doses of sux: | 2mg/kg infants
1mg/kg older kids
2mg/kg IM |
Intubating dose of roc: | Rocuronium - 0.6 mg/kg |
Fentanyl for pediatric surgery: | FENTANYL- 1-2 UQ/KG SUPPLEMENT OR MAJOR 5 UQ/KG & INFUSION 2-4 UQ/KG/HR |
“Sundown sign of Imminent Awakening" | Contraction of the rectus muscle of the eye causing the eyeball to look downward toward the toes. |
What could be the cause of a blue but well ventilated child? | PFO |
What's the treatment for a blue but well ventilated child with a PFO? | 100% O2 & it will resolve. |
Etiology of child with PFO turning blue on emergence? | Emergence will cause increase in increase in PVR leading to R to L shunt- cyanosis. |
What approximate percentage of exhaled agent do you NEVER want to extubate at? | 0.15-2% |
Criteria for awake extubation: | Grimacing using eyebrows and forehead, opens eyes
Spontaneous eye movement
Purposeful movement, reaching for endotracheal tube
Opens mouth with oral suction |
You can assess the adequacy of your fluid replacement by urine output, which should be... | 1-2 ml/kg/hr. |
EBV for various ages: | Preterm - 90-100
Term - 80-90
3mo-1yr - 70-80
Child - 70
Obese - 60-65 |
For infants and neonates a sudden drop in BP = | Sudden drop in volume (blood loss). |
What can you replace 1 mL of blood with? | - 3 mL of crystalloid
- 1 mL of colloid
- 1 mL of whole blood
- .5 mL of PRBC |
What is the crit of PRBC? | 75% |
How much PRBC to give (formula)? | PRBCs (ml) = [(blood loss –ABL) x desired Hct] ÷ Hct of PRBCs (75%) |