PICU Stuff

Sleepy Time

100

This benzodiazepine is often used for procedural sedation and has a relatively rapid onset.

Midazolam (Versed)

200

I’m an opioid infusion in the PICU; at higher doses I can contribute to hypotension and chest wall rigidity.

Fentanyl

300

If you’re aiming for sedation with comparatively less respiratory depression, I’m often called ‘analgosedation’ and frequently used as an infusion.

Dexmedetomidine (AKA Dex, a2 agonist)

400

I’m an opioid used for analgesia and sedation in many PICUs; I can cause histamine release (think flushing/bronchospasm risk) and hypotension in some patients—what am I?

Morphine

500

I’m a dissociative anesthetic used for procedural sedation; I can cause hypertension/tachycardia and is less likely to depress respiration compared with some alternatives—what am I?

Ketamine (NMDA blocker)

Pump and Pipes

100

When pediatric septic shock presents with hypotension, I’m a common first-line vasopressor.

Norepinephrine (a1 for BP --> b1 for chrono/inotropy)  

200

I’m mainly an inotrope with some vasoconstriction—often considered with myocardial dysfunction.

Epinephrine (b2 > b1 --> b1 > b2 --> b1+a1 > b2)

300

I’m the inotrope that’s most associated with improving contractility via increased cAMP while often also causing some vasodilation; commonly considered when there’s low cardiac output in the PICU—what am I?

Dobutamine (b1 > b2)

400

I’m a non-sympathomimetic used as an adjunct for refractory shock in some protocols.

Vasopressin (v1: vasoconstriction, v2: increased H2O reabsorption, v3: ACTH release)

500

I’m not a medication or vasopressor—I’m an extracorporeal life support technique used in refractory cardiac or respiratory failure in PICU; what am I?

ECMO (Extracorporeal membrane oxygenation)

Breathing Bad

100

A key lung-protective strategy is using ‘low’ stretch—what ventilation setting target is commonly paired with this concept?

Low TV

200

I provide a set tidal volume pattern with variable pressures depending on compliance. What mode am I?

VC (volume-control)

300

If PaCO₂ is trending high, what physiologic lever do you increase to clear CO₂?

Minute Ventilation (MV)

400

I’m an oxygen delivery device used for patients who need higher FiO₂ than a nasal cannula and can help deliver controlled oxygen flow—what am I?

Venturi Mask

500

If you’re worried about barotrauma risk, which general parameter would you aim to keep low?

Peak (or Plateau) pressure

Uh Oh Sepsis

100

Septic shock is recognized—what is the immediate time-critical next step emphasized?

IV broad-spectrum antibiotics

200

Monitoring lactate kinetics to assess response in shock—what term?

Lactate clearance or lactate trend

300

Time window target from recognition to antibiotic administration in common bundles—what is it?

1 hour

400

For refractory septic shock with suspected adrenal insufficiency, what medication is commonly used?

Hydrocortisone

500

Besides antibiotics, what other time-critical component is commonly paired early in septic shock resuscitation?

IV fluids (usually LR)

Into My Veins

100

I’m an isotonic crystalloid used for initial fluid boluses.

Normal saline (0.9% NaCl by mass or 154 mEq)

200

I’m the treatment that is used urgently in hyperkalemia—what am I?

Calcium gluconate (for K > 6.5, EKG changes, or rapidly rising K levels)

300

After hypoglycemia treatment, the immediate goal is to stabilize the brain’s energy needs—what is the typical immediate goal and to what level?

Restore/normalize glucose, keep > ~70 mg/dL

400

In massive transfusion, besides RBCs, what key component is classically included early to reduce coagulopathy risk?

Plasma

500

PCC is used to rapidly correct certain coagulopathies in bleeding; what factors does PCC contain?

II, VII, IX, and X (Vitamin K dependent)