II. Criteria: Body habitus
- Age: 0-2 months
- Length: 57-61 cm
- Weight: 5 kg
III. Findings: Vital Signs (normal)
- Heart Rate: 120-180/minute
- Respiratory Rate: 40-60/minute
- Systolic Blood Pressure: 65-95 mmHg
IV. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation
- Pretreatment
- Atropine 0.1 mg
- Induction (Sedation)
- Paralytic
- Succinylcholine 10 mg
- Rocuronium 5 mg
- Vecuronium 0.5 mg
- Sedation Maintenance
- Lorazepam 0.25 mg
- Equipment
- ET Size cuffed (preferred): 3.0 mm
- ET Size uncuffed: 3.5 mm
- ET Insertion depth (at lips): 10-10.5 cm
- Laryngoscope Blade: 1 Miller (straight)
- Suction catheter: 8 F
- LMA: 1
- Tidal Volume: 30-50 cc
- Breath rate: 20-25/min
- Inspiratory time: 0.6 sec
V. Protocol: Miscellaneous Equipment
- Urinary Catheter: 5-6 F
- Nasogastric Tube: 5-6 F
- Chest Tube: 10-12 F
VI. Protocol: Fluids
- IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 100 ml
- IV Fluid Crystalloid Maintenance: 20 ml/h
VII. Protocol: Resuscitation
- Cardioversion
- First (1 J/kg): 5 J
- Next (2 J/kg): 10 J
-
Defibrillation
- First (2 J/kg): 10 J
- Next (4 J/kg): 20 J
- Next (4-10 J/kg): 20-50 J
-
Lidocaine
- Intravenous (100 mg/5 ml = 2%): 5 mg (0.25 ml)
- Endotracheal (100 mg/5 ml = 2%): 10-15 mg (0.5 to 0.75 ml)
-
Epinephrine
- Intravenous (1:10,000): 0.05 mg (0.5 ml)
- Endotracheal (1:1000): 0.5 mg (0.5 ml)
-
Atropine
- Intravenous (0.1 mg/ml): 0.1 mg (1 ml)
- Endotracheal (0.4 mg/ml) 0.25 mg (0.63 ml)
-
Naloxone
- Intravenous (0.4 mg/ml) 0.05 mg (0.13 ml)
- Endotracheal (0.4 mg/ml) 0.05 mg (0.13 ml)
-
Adenosine
- Initial dose (6 mg/2ml): 0.5 mg (0.17 ml)
- Next dose (6 mg/2ml): 1.0 mg (0.33 ml)
-
Amiodarone
- Intravenous (50 mg/ml): 25 mg (0.5 ml)
-
Calcium Chloride
- Intravenous (100 mg/ml = 10%): 100 mg (1.0 ml)
-
Magnesium Sulfate
- Intravenous (5 g/10 ml = 500 mg/ml = 4 meq Mg/ml = 50%) 250 mg (0.5 ml)
-
Sodium Bicarbonate (use 4.2% bicarbonate for under age 3 months)
- Intravenous (2.5 meq/5ml = 42 mg/ml = 4.2%) 5 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