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)
- Heart Rate: 110-170/minute
- Respiratory Rate: 20-30/minute
- Systolic Blood Pressure: 70-110 mmHg
IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation
- Induction (Sedation)
- Paralytic
- Succinylcholine 20 mg
- Rocuronium 10 mg
- Vecuronium 1 mg
- Sedation Maintenance
- Lorazepam 0.5 mg
- Equipment
- ET Size cuffed (preferred): 3.5 mm
- ET Size uncuffed: 4.0 mm
- ET Insertion depth (at lips): 11-12 cm
- Laryngoscope Blade: 1 Miller (straight)
- Suction catheter: 8-10 F
- LMA: 2
- Tidal Volume: 65-105 cc
- Breath rate: 15-25/min
- Inspiratory time: 0.7 sec
V. Protocol: Miscellaneous Equipment
- Urinary Catheter: 8-10 F
- Nasogastric Tube: 8-10 F
- Chest Tube: 16-20 F
VI. Protocol: Fluids
- IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 200-220 ml
- IV Fluid Crystalloid Maintenance: 41-43 ml/h
VII. Medications: Resuscitation
- Cardioversion
- First (1 J/kg): 10 J
- Next (2 J/kg): 20 J
-
Defibrillation
- First (2 J/kg): 20 J
- Next (4 J/kg): 40 J
- Next (4-10 J/kg): 40-100 J
-
Lidocaine
- Intravenous (100 mg/5 ml = 2%): 10 mg (0.5 ml)
- Endotracheal (100 mg/5 ml = 2%): 20-30 mg (1.0-1.5 ml)
-
Epinephrine
- Intravenous (1:10,000): 0.1 mg (1 ml)
- Endotracheal (1:1000): 1 mg (1 ml)
-
Atropine
- Intravenous (0.1 mg/ml): 0.21 mg (2.1 ml)
- Endotracheal (0.4 mg/ml) 0.5 mg (1.3 ml)
-
Naloxone
- Intravenous (0.4 mg/ml) 0.11 mg (0.28 ml)
- Endotracheal (0.4 mg/ml) 0.11 mg (0.28 ml)
-
Adenosine
- Initial dose (6 mg/2ml): 1 mg (0.33 ml)
- Next dose (6 mg/2ml): 2.1 mg (0.7 ml)
-
Amiodarone
- Intravenous (50 mg/ml): 50 mg (1 ml)
-
Calcium Chloride
- Intravenous (100 mg/ml = 10%): 210 mg (2.1 ml)
-
Magnesium Sulfate
- Intravenous (5 g/10 ml = 500 mg/ml = 4 meq Mg/ml = 50%) 525 mg (1.1 ml)
-
Sodium Bicarbonate
- Intravenous (1 meq/ml = 84 mg/ml = 8.4%) 10 meq (10 ml)
VIII. References
- eBroselow
- Broselow (2011) Broselow Pediatric Emergency Tape, Vital Signs, Inc, Totowa, NJ
- LA County EMS Color Coded Pediatric Drugs
- Difficult Airway Course
- (2008) Fairview University - Childrens Hospital, Pediatric Emergency Drug Guide