Bundles of Joy
Having kids is a lot like college: up all night, lots of puking, and broke
If I go missing, follow my kids, they can find me anywhere
One child makes you a parent, two makes you a referee
Hell hath no fury like the child who didn't get to push the elevator buttons
100

28 days or younger, APGAR scoring system, inverted pyramid

Neonate

100

narrower airways, obligate nose breathers, larger tongue, soft trachea

airway differences between adult and child
100

Limited store of glycogen and glucose, greater BSA-to-weight ratio, Significant volume loss can result from vomiting and diarrhea

Metabolic differences compared to adults

100

Toe-to-head approach for younger child, Head-to-toe approach for older child, Pupils, Capillary refill, Pulse oximetry

patient assessment steps
100

DOPE

pneumonic to trouble shoot airway management (intubation, vent, etc.)

200

1 month-1 year, explores through their mouth, increased risk of FBAO

infants

200

reason for teacup touch, fragile like tissue paper, less protection for organs, diaphragmatic breathers

chest and lung airway considerations

200

Appearance, work of breathing, circulation

Pediatric Assessment Triangle (PAT)

200

foreign body cannot be removed with Magill forceps and impossible to intubate around it, can't intubate, can't ventilate

Needle cricothyrotomy

200

▪Newborn/infant: 8.0 French

▪Toddler/preschooler: 10 French

▪School-age children: 12 French

▪Adolescents: 14–16 French

NG/OG tube sizes

300

ages 1-3; language develops, simple questions/answers

toddlers

300

breath sounds easily transmitted bilaterally

auscultate via axillary regions
300

indicates hypoxia; ominous sign of impending cardiac arrest, sinus tachycardia in response to stress.

Heart rate

300

16 + age/4

tube size formula

300

Administer initial dosage of 2 to 4 joules per kilogram of body weight then double

electrical therapy

400

ages 3-5, vivid imaginations, frighten easily

preschoolers

400

Require double the metabolic oxygen. Proportionately smaller oxygen reserves. Especially susceptible to hypoxia.

Oxygenation differences compared to adults
400

Respiratory rate greater than 60, heart rate greater than 180 (over age 1), greater than 220 (under age 1)

impending cardiovascular collapse

400

70 + 2 * age

decompensated shock formula

400

▪Irritability or anxiety deteriorating to lethargy, Marked retractions deteriorating to agonal respirations, bradycardia

Respiratory Failure

500

ages 6-12; develops modesty, toys calm, understands the idea of friends and relationships

school-age 

500

Shock assessment based on clinical signs of tissue perfusion (cap refill). Child may be in shock despite normal blood pressure

higher index of shock suspicion with tachycardia

500

Bulb syringe, flexible suction catheter, or rigid-tip suction catheter, depending on patient's age or size. Decrease suction pressure to less than 100 mmHg in infants

suction process in infants and children

500

gastric distention in unresponsive patient, Inability to achieve adequate tidal volumes during ventilation

NG/OG tube required

500

viral infection of upper airway, Edema beneath glottis and larynx; narrowing lumen of airway

Laryngotracheobronchitis (croup)

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