Pedia Notes

NOTES
72
NOTES
72
FLUIDS (Ludans Method)
NOTES
Fluid Challenge: 20cc/kg/h of D5LRS; can be done 3x; max of

500cc
Maint
Hydration
Wt (kg)
(kg)
Mil
Mod
Sev
50 cc
100 cc
150 cc
30 cc
60 cc
90 cc
03
75
<15
3 10
100
>15
11 20
75
21 30
60
31 40
50
>40
40
Mil
D50.3 NaCl in 6 hours
Mod
D5LRS in 1 hour;
Sev
1/3 D5LRS in 1 hour;
2/3 D5 0.3 NaCl in 5 hours
Insensible water loss = 400 ml/m2 +
daily urine loss
<15 kg D5 IMB
>15 kg D5 NM
FLUID RESTRICTION
Total Fluids = BSA (400) + urine output

IVF = TF rate
KVO = 5 cc/h
Oral = TF IVF
super KVO = 2cc/h
M2 Cardiac
1 5 kg
(wt) (0.05) + 0.05
6 11 kg
(wt) (0.04) + 0.1
12 20 kg
(wt) (0.03) + 0.2
>20 kg
(wt) (0.02) + 0.4
M2 Renal / Hema
[(wt) (4) + 7]
(wt) + 90
If no UO; (1cc/k/h) + BSA (400)
71
FLUIDS (Ludans Method)
NOTES
Fluid Challenge: 20cc/kg/h of D5LRS; can be done 3x; max of

500cc
Maint
Hydration
Wt (kg)
(kg)
Mil
Mod
Sev
50 cc
100 cc
150 cc
30 cc
60 cc
90 cc
03
75
<15
3 10
100
>15
11 20
75
21 30
60
31 40
50
>40
40
Mil
Mod
D5LRS in 1 hour;
Sev
1/3 D5LRS in 1 hour;
2/3 D5 0.3 NaCl in 5 hours
Insensible water loss = 400 ml/m2 +
daily urine loss
<15 kg D5 IMB
>15 kg D5 NM
FLUID RESTRICTION
Total Fluids = BSA (400) + urine output

IVF = TF rate
KVO = 5 cc/h
Oral = TF IVF
super KVO = 2cc/h
M2 Cardiac
1 5 kg
(wt) (0.05) + 0.05
6 11 kg
(wt) (0.04) + 0.1
12 20 kg
(wt) (0.03) + 0.2
>20 kg
(wt) (0.02) + 0.4
M2 Renal / Hema
[(wt) (4) + 7]
(wt) + 90
If no UO; (1cc/k/h) + BSA (400)
71
NOTES
Solution
Na
Cl
Mg
Cal
Breastmilk
22
36
28
28
24/oz
Intralipid 10%
2.5
0.5
1100
Intralipid 20%
2.5
0.5
2000
Aminosyn
3.5%
Albumin
40
18.4
40
100
<120
140
1000
FLUIDS (Holliday-Segar Method)

Weight [kg]
Caloric Expenditure in 24h
0-10
100 kcal/kg
11-20
1000 kcal + 50 kcal/kg for each kg>10
Above 20
FLUIDS (BSA Method)

Weight [kg]

1500 ml/m2
Water
70
Sodium
potassium
NOTES
Solution
Na
Cl
Mg
Cal
Breastmilk
22
36
28
28
24/oz
Intralipid 10%
2.5
0.5
1100
Intralipid 20%
2.5
0.5
2000
Aminosyn
3.5%
Albumin
40
18.4
40
100
<120
140
1000
FLUIDS (Holliday-Segar Method)

Weight [kg]
0-10
100 kcal/kg
11-20
Above 20
FLUIDS (BSA Method)

Weight [kg]
Water
70

1500 ml/m2
Sodium
potassium
154
51
25
40
140
90
45
90
90
30
PNSS
D5 .03% NaCl
D5 IMB
D5 NM
D5 NR
Oresol
Pedialyte 90
Pedialyte 45
Hydrite
Glucolyte
69
Action Plan
Complications
Head Bobbing
Cyanosis
Grunting
Apnea
Sensorium
Awake
OPD + FF
up after 3D
Awake
-
OPD + FF
up after tx
Admit to
ward
+
Irritable
+
IC/SC
PCAP C
Moderate
Risk
Ca
3
28
170
170
170
170
Cal
170
Admit to ICU,
refer to specialist
+
+
+
Lethargic
+
IC/SC/
Supraclav
+
PCAP D
High Risk
Mg
154
51
25
40
140
90
45
90
90
30
PNSS
D5 .03% NaCl
D5 IMB
D5 NM
D5 NR
Oresol
Pedialyte 90
Pedialyte 45
Hydrite
Glucolyte
Variables
Na
130
Solution
D5LRS
Action Plan
Complications
Head Bobbing
Cyanosis
Grunting
Apnea
Sensorium
Retraction
27
16
HCO3
28
Retraction
PCAP B
Low Risk
28
30
98
40
22
51
154
Cl
109
Signs of Respiratory
Failure
PCAP A
Minimal Risk
20
20
20
20
20
13
20
K
4
69
Signs of Respiratory
Failure
Variables
Na
130
Solution
D5LRS
4
OPD + FF
up after tx
Awake
-
PCAP A
Minimal Risk
20
20
20
20
20
13
20
K
4
27
16
HCO3
28
OPD + FF
up after 3D
Awake
-
PCAP B
Low Risk
28
30
98
40
22
51
154
Cl
109
Admit to
ward
+
Irritable
+
IC/SC
PCAP C
Moderate
Risk
Ca
3
28
170
170
170
170
Cal
170
Admit to ICU,
refer to specialist
+
+
+
Lethargic
+
IC/SC/
Supraclav
+
PCAP D
High Risk
Mg
>70/min
>50/min
>35/min
>60/min
>50/min
>35/min
>50/min
>40/min
>30/min
>50/min
>40/min
>30/min
<11 mos
<11 mos
>11 mos
>11 mos
+
+
Severe
Moderate
Mild
-
+
+
+
-
PCAP D
High Risk
PCAP C
Moderate
Risk
+`
PCAP B
Low Risk
PCAP A
Minimal Risk
cc/kg/day
D
PT
SGA
VLBW
06d
120
80
70
60
4060
150
90
80
80
50
10d 12m
1 3y
100
90
100
60
4 6y
120
110
100
150
70
7 9y
180
120
110
180
80
10 12y
80
130
120
200
90
13 15y
70
140
130
220
100
>15y
50
150
140
240
110
RRe
2-12 mos
1-5 yrs
>5 yrs
Age
Can Feed
Dehydrationd
Compliant
Caregiverc
Able to FF upc
Co-Morbidb
140
BURN: GALVESTON FORMULA
1st 24 h
Variables
RISK CLASSIFICATION OF PNEUMONIA-RELATED MORTALITY
DAILY FLUID REQUIREMENT
5 L/m2 burned BSA +

2 L/m2 total BSA
in 8h using LRS
in 16
3.750 L/m2 burned BSA +
1.500 L/m2 total BSA
nd
2 24 h
24h maintenance fluid

68
>70/min
>50/min
>35/min
>60/min
>50/min
>35/min
>50/min
>40/min
>30/min
>50/min
>40/min
>30/min
<11 mos
<11 mos
>11 mos
>11 mos
+
+
Severe
Moderate
Mild
-
+
+
+
-
PCAP D
High Risk
PCAP C
Moderate
Risk
+`
PCAP B
Low Risk
PCAP A
Minimal Risk
cc/kg/day
D
PT
SGA
VLBW
06d
120
80
70
60
4060
150
90
80
80
50
10d 12m
1 3y
100
90
100
60
4 6y
120
110
100
150
70
7 9y
180
120
110
180
80
10 12y
80
130
120
200
90
13 15y
70
140
130
220
100
>15y
50
150
140
240
110
BURN: GALVESTON FORMULA
RRe
2-12 mos
1-5 yrs
>5 yrs
Age
Can Feed
Dehydrationd
Compliant
Caregiverc
Able to FF upc
Co-Morbidb
1st 24 h
Variables
RISK CLASSIFICATION OF PNEUMONIA-RELATED MORTALITY
DAILY FLUID REQUIREMENT
nd
2 24 h
5 L/m2 burned BSA +

2 L/m2 total BSA
in 8h using LRS
in 16
3.750 L/m2 burned BSA +
1.500 L/m2 total BSA
24h maintenance fluid
68
140
BURN: PARKLAND FORMULA

1st 24 h
nd
2 24 h
ALLERGIC RHINITIS
INTERMITTENT
< 4 days per week OR <4
weeks
MILD
3 ml/kg/% burned BSA (<30%)

4 ml/kg/% burned BSA (>30%)
in 8h using LRS
in 16
50 70% of 1st day
normal sleep
normal daily activities
normal work and
school
no trouble some
symptoms
GIR (4-8 CC/K/H)
TFR
TFR = __ x BW
Target Feed =
TFR/8
(or # of feeding/
day)
(0.167 x dext) IV rate

present wt (kg)
D5 = 5
D7.5 = 0.0555
D10 = 0.111
D12.5 = 0.166
CAL IV
CAL MF
Dext x 4 x 24 x rate
------------------------
Vol cc x 8 x ___ cal

-----------------------30 oz
wt in kg
Corn Oil
Karo
MCT
Total Cal = Cal IV + Cal MF
Target Feed:
TPN > 8 divided feeds (q3)
8 cal/cc
6 cal/cc
7.7 cal/cc
Sneezers and Runners
Blockers
Sneezing
Especially paroxysmal
Little or none
Rhinorrhea
Watery, anterior and

posterior
Thick mucous, more

posterior
Itching
Yes
No
Nasal
blockage
Variable
Often severe
Diurnal
rhythm
Worse during day,

improving at night
Constant, day and night,

may be worse at night
Conjunctivitis
Often present
67
BURN: PARKLAND FORMULA

1st 24 h
nd
2 24 h
ALLERGIC RHINITIS
INTERMITTENT
< 4 days per week OR <4
weeks
MILD
3 ml/kg/% burned BSA (<30%)

4 ml/kg/% burned BSA (>30%)
in 8h using LRS
in 16
50 70% of 1st day
TFR
Target Feed =
TFR/8
(or # of feeding/
day)
normal sleep
normal daily activities
normal work and
school
no trouble some
symptoms
GIR (4-8 CC/K/H)
TFR = __ x BW
(0.167 x dext) IV rate
present wt (kg)
D5 = 5
D7.5 = 0.0555
D10 = 0.111
D12.5 = 0.166
CAL MF
Dext x 4 x 24 x rate
------------------------
Vol cc x 8 x ___ cal

------------------------
100
wt in kg
FT = 20 cal/oz
PT = 24 cal/oz
Corn Oil
Karo
MCT
Total Cal = Cal IV + Cal MF
Target Feed:
TPN > 8 divided feeds (q3)
PERSISTENT
> 4 days per week OR >4
weeks
MILD
abnormal sleep
impairment of daily
activities, sport,
leisure
problems caused at
work and school
troublesome
symptoms
History of nasal discharge, blockage, sneeze/itch

2 or more symptoms for >1 hour on most days
Rate = TFR/24h
CAL IV
abnormal sleep
impairment of daily
activities, sport,
leisure
problems caused at
work and school
troublesome
symptoms
History of nasal discharge, blockage, sneeze/itch

2 or more symptoms for >1 hour on most days
Rate = TFR/24h
100
wt in kg
FT = 20 cal/oz
PT = 24 cal/oz
PERSISTENT
> 4 days per week OR >4
weeks
MILD
30 oz
wt in kg
8 cal/cc
6 cal/cc
7.7 cal/cc
67
Sneezers and Runners
Blockers
Sneezing
Especially paroxysmal
Little or none
Rhinorrhea
Watery, anterior and

posterior
Thick mucous, more

posterior
Itching
Yes
No
Nasal
blockage
Variable
Often severe
Diurnal
rhythm
Worse during day,

improving at night
Constant, day and night,

may be worse at night
Conjunctivitis
Often present
If the patient
has chronic
diarrhoea,
severe undernutrition, or
high fever treat
or refer to the
nearest health
clinic for treatment. If there is
blood or mucus
in the stool and
high fever,
suspect dysentery and treat
with antimicroUse
Plan C
Na++[135 145 meqs/

L]
Na Corxn = Deficit +
K+ [3.5 5.5 meqs/L]
Maintenance
K Corxn = Deficit + MainteDeficit = (D - A) x 0.6 x
nance
kg
Deficit = (4 - A) x 0.6 x kg
Maintenance = 3
Maintenance = 2 mEqs x kg
mEqs x kg
KCl Prep = 2 mEqs/L
NaCl Prep = 2.5
mEqs/L
Eg: 4kg; Na = 130; K = 3.2; using 391.2cc D5IMB
(Na = 25; K = 20)
Use
Plan B
Na Maint = 3 mEqs x 4 kg = 12 mEqs

D5IMB Na: 25:1000::?:391.2cc
? = 9.78mEqs
12 mEqs 9.78mEqs = 2.22mEqs/2.5 NaCl = 0.88cc
NaCl incorporation
K Maint = 2 mEqs x 4 kg = 8 mEqs
K Def = (4 3.2mEqs) 4kg x 0.6 = 1.92 mEqs
Total K = 8 + 1.92 = 9.92 mEqs
D5IMB K: 20:1000:: ?:391.2
? = 7.82 mEqs
9.92 mEqs 7.82mEqs = 2.1mEqs/2.0 KCl = 1 cc KCl
incorprtn
Use
Plan A
If the patient has

two or more of
these danger signs,
he has severe
dehydration
The patient
has no signs
of dehydration
No weight
loss during
diarrhoea
Loss of 25-100
grams for each
kilogram of
weight
If the patient
has two or more
of these signs,
he has some
dehydration
Loss of more than

100 grams for each
kilogram of weight
High fever 38.5C (or

101F) or
greater
ELECTROLYTES
Ca Gluconate
hypocal, tetany
6. Decide
5. Weigh, if
possible
4. Take Temperature
Anion Gap= (Na+K) - (Cl+HCO3) *NV: 12=/-2

100/1x10
amp
ELECTROLYTES
Use
Plan C
Na++[135 145 meqs/

L]
Na Corxn = Deficit +
K+ [3.5 5.5 meqs/L]
Maintenance
K Corxn = Deficit + MainteDeficit = (D - A) x 0.6 x
nance
kg
Deficit = (4 - A) x 0.6 x kg
Maintenance = 3
Maintenance = 2 mEqs x kg
mEqs x kg
KCl Prep = 2 mEqs/L
NaCl Prep = 2.5
mEqs/L
Eg: 4kg; Na = 130; K = 3.2; using 391.2cc D5IMB
(Na = 25; K = 20)
Use
Plan B
Na Maint = 3 mEqs x 4 kg = 12 mEqs

D5IMB Na: 25:1000::?:391.2cc
? = 9.78mEqs
12 mEqs 9.78mEqs = 2.22mEqs/2.5 NaCl = 0.88cc
NaCl incorporation
K Maint = 2 mEqs x 4 kg = 8 mEqs
K Def = (4 3.2mEqs) 4kg x 0.6 = 1.92 mEqs
Total K = 8 + 1.92 = 9.92 mEqs
D5IMB K: 20:1000:: ?:391.2
? = 7.82 mEqs
9.92 mEqs 7.82mEqs = 2.1mEqs/2.0 KCl = 1 cc KCl
incorprtn
Use
Plan A
If the patient has

two or more of
these danger signs,
he has severe
dehydration
The patient
has no signs
of dehydration
No weight
loss during
diarrhoea
Loss of 25-100
grams for each
kilogram of
weight
If the patient
has two or more
of these signs,
he has some
dehydration
Loss of more than

100 grams for each
kilogram of weight
High fever 38.5C (or

101F) or
greater
If the patient
has chronic
diarrhoea,
severe undernutrition, or
high fever treat
or refer to the
nearest health
clinic for treatment. If there is
blood or mucus
in the stool and
high fever,
suspect dysentery and treat
with antimicro-
66
Wt x 200
100
66
Ca Gluconate
hypocal, tetany
6. Decide
5. Weigh, if
possible
4. Take Temperature
Anion Gap= (Na+K) - (Cl+HCO3) *NV: 12=/-2
Wt x 200
100
100/1x10
amp
Chronic Respiratory Alkalosis
0.3 x wt x BE 2 + D5W
without O2:
Adequate = 80 100
More than adequate >100
Mild Hypoxemia 60 79
65
Normal
Normal
Fontanelle
goes back
quickly
Pulse
3. Feel
Skin turgor
Very fast and

deep
Faster than
normal
Normal
Fontanelle
Very fast, weak,

or you cannot feel
Very sunken
Faster than
normal
Sunken
Pulse
goes back very

slowly
goes back
slowly
3. Feel
Skin turgor
Mouth &
Tongue
Breathing
Dry
Wet
Mouth &
Tongue
Breathing
Eyes
Very dry and

sunken
Very dry
Sunken
Normal
Eyes
Absent
Condition
Tears
Present
Tears
Severe undernutrition
Very sleepy, unconscious, floppy
Unwell, sleepy
or irritable
65
Absent
Well, Alert
0.3 x wt x BE 2 + D5W
Normal
Normal
goes back
quickly
Normal
Wet
Normal
Present
Well, Alert
Less than 4
Chronic Respiratory Alkalosis
Condition
Metabolic Acidosis Correction

HCO3 = (BE) (0.3) (weight) / 2 OR 1mEq/kg
slow IV push; drip 30 mins
More than 10
ARTERIAL BLOOD GASES

Normal Values:
PH
7.35 7.45 (7.4)
pCO2
35 49 (40)
pO2
80 100
HCO3
22 26BE 2
O2 Sat
97%
Anion Gap = 12 2
4 to 10
ACID BASE BALANCE
Less than 4
2. Look At
without O2:
Adequate = 80 100
More than adequate >100
Mild Hypoxemia 60 79
Longer than
3 weeks duration
Sunken
Faster than
normal
goes back
slowly
Faster than
normal
Dry
Sunken
Absent
Unwell, sleepy
or irritable
4 to 10
liquid stools per day
Metabolic Acidosis Correction

HCO3 = (BE) (0.3) (weight) / 2 OR 1mEq/kg
slow IV push; drip 30 mins
Very sunken
Very fast, weak,

or you cannot feel
goes back very

slowly
Very fast and

deep
Very dry and

sunken
Very dry
Absent
Very sleepy, unconscious, floppy
More than 10
Severe undernutrition
Longer than
3 weeks duration
ARTERIAL BLOOD GASES

Normal Values:
PH
7.35 7.45 (7.4)
pCO2
35 49 (40)
pO2
80 100
HCO3
22 26BE 2
O2 Sat
97%
Anion Gap = 12 2
2. Look At
ACID BASE BALANCE
Blood or Mucus in
the stool
Met Alkalosis: meq/L inc in HCO3 = 0.5 1 mmHg inc in PCO2

55
Unable to
drink
No urine for 6
hours
Acute Resp Acidosis: HCO3 inc by 3 4 meq/L30 when pH is

normal
Acute Resp Alkalosis: HCO3 dec by 2 4 meq/L18 when pH is
normal
Chronic Resp Acidosis: mmHg inc in pCO2 = 0.4 meq/L inc in
HCO3
45
Chronic Resp Alkalosis: mmHg dec in pCO2 = 0.5 meq/L dec in
HCO3
12 15
Greater than
normal
A small
amount, dark
Thirst
Indications for Intubation
Normal
Absolute Indications
Prolonged apnea
pO2 < 50 on FiO2 > 80, may not apply to Infant with cyanotic CHD (38.5)
pCO2 > 60 with persistent acidemia (75)
General anaesthesia
Relative Indications
Frequent intermittent apnea unresponsive to drug therapy
early treatment when use of a mechanical ventilator is anticipated because of
deteriorating gas exchange
relieving work of breathing in an infant with signs of respiration difficulty
initiation of exogenous surfactant therapy in infants with RDS
REFLOW PHENOMENON elimination of CPAP produces closure

of alveoli, causing atelectasis
ET Size (mm)= (16+ age in yrs. )/4
Urine
Very frequent
Some
Met Acidosis: pCO2 = 1.5 (HCO3) + 8.4 2

10 mmHg
None or a small
amount
Normal
Vomiting
Less than 4
4 to 10
More than 10
longer than
3 weeks duration
Chronic diarrhea
1. Ask
About
Diarrhoea
Division of Diarrheal and Acute Respiratory Disease Control

Treatment of Diarrhea: A manual for physicians and other senior health workers
THE TREATMENT OF DIARRHOEA
ACID BASE DISORDERS CORRECTION
64
64
Blood or Mucus in
the stool
Met Alkalosis: meq/L inc in HCO3 = 0.5 1 mmHg inc in PCO2

55
Unable to
drink
No urine for 6
hours
Acute Resp Acidosis: HCO3 inc by 3 4 meq/L30 when pH is

normal
Acute Resp Alkalosis: HCO3 dec by 2 4 meq/L18 when pH is
normal
Chronic Resp Acidosis: mmHg inc in pCO2 = 0.4 meq/L inc in
HCO3
45
Chronic Resp Alkalosis: mmHg dec in pCO2 = 0.5 meq/L dec in
HCO3
12 15
Greater than
normal
A small
amount, dark
Thirst
Indications for Intubation
Normal
Absolute Indications
Prolonged apnea
pO2 < 50 on FiO2 > 80, may not apply to Infant with cyanotic CHD (38.5)
pCO2 > 60 with persistent acidemia (75)
General anaesthesia
Relative Indications
Frequent intermittent apnea unresponsive to drug therapy
early treatment when use of a mechanical ventilator is anticipated because of
deteriorating gas exchange
relieving work of breathing in an infant with signs of respiration difficulty
initiation of exogenous surfactant therapy in infants with RDS
REFLOW PHENOMENON elimination of CPAP produces closure

of alveoli, causing atelectasis
ET Size (mm)= (16+ age in yrs. )/4
Urine
Very frequent
Some
Met Acidosis: pCO2 = 1.5 (HCO3) + 8.4 2

10 mmHg
None or a small
amount
Normal
Vomiting
Less than 4
4 to 10
More than 10
longer than
3 weeks duration
Chronic diarrhea
1. Ask
About
Diarrhoea
Division of Diarrheal and Acute Respiratory Disease Control

Treatment of Diarrhea: A manual for physicians and other senior health workers
THE TREATMENT OF DIARRHOEA
ACID BASE DISORDERS CORRECTION
Band:Neutro Ratio= (Stabs+ Mono)/Neutro

*NV= <0.02
IT= (Stabs+ Mono)/ Total WBC
ANC= WBC x segs *NV=>1500
Band:Neutro Ratio= (Stabs+ Mono)/Neutro

*NV= <0.02
IT= (Stabs+ Mono)/ Total WBC
ANC= WBC x segs *NV=>1500
63
> 80% predicted

variability 20 30%
> 80% predicted
variability 20 30%
>60 and <80%

predicted
Variability >30%
< 60% prpedicted

variability >30%
>2 times a month
>1 time a week
<1 time a week

< 2 times a month
> 80% predicted
asymptomatic and
Variability < 20%
normal PEF between attacks
Presence of 1 feature warrants classification into the higher category; Any patient can have
severe attacks
(+) coombs hemolytic, congenital

(-) coombs acquired
STEP 1
Intermittent
ABO setup no manifestation

ABO disease ABO setup with disease
STEP 3
Moderate Persistent
Urticaria due to transfused protein; Tx: Benadryl
Frequent
Total blood volume = wt (Kg) x 80cc/Kg = ____ cc

Transfusion Reaction
Fever/Chills due to transfused leucocytes;
Tx: steroids
Continuous
Limited physical
activity
Daily
Use Beta-agonist
daily
Attacks affect activity
>1 time a week
but <1 time a day
10cc/kg = 2ml/kg pRBC will inc

Hgb by 0.5 1 g/dl
FWB
20cc/kg = inc Hgb by 10
Platelet concentrate 15 20cc/kg
Fresh Frozen Plasma 15 cc/kg
Cryoprecipitate
1 u/6kg
NIGHTTIME SYMPTOMS
pRBC
SYMPTOMS
Wt x blood volume x (desired Hct actual Hct)

Hct of blood to be transfused
CLINICAL
FEATURES
BEFORE
TREATMENT
STEP 4
Severe Persistent
ASTHMA CLASSIFICATION AND SEVERITY (GINA Guidelines)
Shock associated with blood loss

Hgb <13, Hct <40 and pulmonary failure: CHD or CHF
commulative loss of 10% or more of blood volume within 72 hours
Hgb <8, Hct <25 in a stable neonate with clinical manifestations of
anemia: tachcardia, tachpnea, poor feeding
PEF
Indications for Blood Transfusion
10
>2 times a month
>60 and <80%

predicted
Variability >30%
>1 time a week
< 60% prpedicted

variability >30%
Frequent
63
STEP 2
Mild Persistent
10
<1 time a week

< 2 times a month
> 80% predicted
asymptomatic and
Variability < 20%
normal PEF between attacks
Presence of 1 feature warrants classification into the higher category; Any patient can have
severe attacks
(+) coombs hemolytic, congenital

(-) coombs acquired
STEP 1
Intermittent
ABO setup no manifestation

ABO disease ABO setup with disease
STEP 2
Mild Persistent
Urticaria due to transfused protein; Tx: Benadryl
STEP 3
Moderate Persistent
Total blood volume = wt (Kg) x 80cc/Kg = ____ cc

Transfusion Reaction
Fever/Chills due to transfused leucocytes;
Tx: steroids
Continuous
Limited physical
activity
Daily
Use Beta-agonist
daily
Attacks affect activity
>1 time a week
but <1 time a day
10cc/kg = 2ml/kg pRBC will inc

Hgb by 0.5 1 g/dl
FWB
20cc/kg = inc Hgb by 10
Platelet concentrate 15 20cc/kg
Fresh Frozen Plasma 15 cc/kg
Cryoprecipitate
1 u/6kg
NIGHTTIME SYMPTOMS
pRBC
SYMPTOMS
Wt x blood volume x (desired Hct actual Hct)

Hct of blood to be transfused
CLINICAL
FEATURES
BEFORE
TREATMENT
STEP 4
Severe Persistent
ASTHMA CLASSIFICATION AND SEVERITY (GINA Guidelines)
Shock associated with blood loss

Hgb <13, Hct <40 and pulmonary failure: CHD or CHF
commulative loss of 10% or more of blood volume within 72 hours
Hgb <8, Hct <25 in a stable neonate with clinical manifestations of
anemia: tachcardia, tachpnea, poor feeding
PEF
Indications for Blood Transfusion
SaO2% (on
>95%
91-95%
air)
Hypercapnia (hypoventilation) develops more readily in young children than in adults and
adolescents
Phlebotomy:
Goal Hct = 65
>45mmHg; possible respiratory

failure
<90%
PaCO2
And/or
<45mmHg
<45mmHg
Possible cyanosis
<60mmHg
>60mmHg
Normal, test
usually not
necessary
Over 80%
PEF after
initial Bronchodilator
% predicted
or
% personal
best
PaO2 (on air)
Approximately
60 80%
<60% predicted
at personal best
(100L/min adults
or response last
<2hours)
Arrest
Imminent
Mild
Parameter
PEFR: Ht (cm) 100 x 5 + 175 (boys)

Ht (cm) 100 x 5 + 170 (girls)
Moderate
Severe
total blood volume = Wt x 80 x 0.15 or 0.10

PNSS = 10% of total blood volume
FFP = 15% of total blood volume; run 50% in 30 mins prior to phleb;
50% at IV maint during phleb
Desired actual x 80 (wt)
Hct of blood component
pRBC = 70
= IV Mild (D5 0.3% NaCl)
Poisoning:
NathioSO6 15g/100ml H2O
Activated Charcoal: 100g/ 200ml H2O
Mg Citrate: 150-300ml + H2O
Soap Suds Enema: bar Perla + 16 H2O
11
SaO2% (on
>95%
91-95%
air)
Hypercapnia (hypoventilation) develops more readily in young children than in adults and
adolescents
In Dengue
Hemoconcentration={(Hgbx3)-Hct]/Hgbx3
Inc PTT, N PT, N plt, N BT cryoprecipitate
Inc PTT, inc PT, N plt, N BT plasma
Inc PTT, N PT, platelet <100,000, BT >9 platelet conc
Inc PTT, inc PT, platelet <100,000, BT >9 replace blood
Phlebotomy:
Goal Hct = 65
>45mmHg; possible respiratory

failure
<90%
PaCO2
And/or
<45mmHg
<45mmHg
Possible cyanosis
<60mmHg
>60mmHg
Normal, test
usually not
necessary
<60% predicted
at personal best
(100L/min adults
or response last
<2hours)
Over 80%
PEF after
initial Bronchodilator
% predicted
or
% personal
best
PaO2 (on air)
Approximately
60 80%
Mild
Parameter
PEFR: Ht (cm) 100 x 5 + 175 (boys)

Ht (cm) 100 x 5 + 170 (girls)
Moderate
Severe
Arrest
Imminent
62
62
In Dengue
Hemoconcentration={(Hgbx3)-Hct]/Hgbx3
Inc PTT, N PT, N plt, N BT cryoprecipitate
Inc PTT, inc PT, N plt, N BT plasma
Inc PTT, N PT, platelet <100,000, BT >9 platelet conc
Inc PTT, inc PT, platelet <100,000, BT >9 replace blood
total blood volume = Wt x 80 x 0.15 or 0.10

PNSS = 10% of total blood volume
FFP = 15% of total blood volume; run 50% in 30 mins prior to phleb;
50% at IV maint during phleb
Desired actual x 80 (wt)
Hct of blood component
pRBC = 70
= IV Mild (D5 0.3% NaCl)
Poisoning:
NathioSO6 15g/100ml H2O
Activated Charcoal: 100g/ 200ml H2O
Mg Citrate: 150-300ml + H2O
Soap Suds Enema: bar Perla + 16 H2O
11
>15 (260)
>18 (310)
>25 (430)
>30 (510)
>72
>17 (290)
>20 (340)
>25 (430)
>30 (510)
Phototherapy at these TSB levels is a clinical option, meaning that

the intervention is available and may be used on the basis of individual clinical judgment.
Intensive phototherapy (Appendix) should produce a decline of
TSB of 1 to 2 mg/dL within 4 to 6 hours and the TSB level should
continue to fall and remain below the threshold level for exchange
Moderate
Hyperbilirubinemia: Healthy Term Newborn
<110/min
49-72
<110/min
>25 (430)
<120/min
>20 (340)
<120/min
>15 (260)
Normal rate
<160/min
>12 (210)
2-12 months
1-5 years
6-8 years
25-48
Infants
Pre-school
School age
...
bradycardia
...
>120
...
100-120
...
Usually Loud
<=24
Loud
Xtrans and
Photo Fails
Paradoxical
thoracoabdominal
movement
Absence of
wheeze
Xtrans if
Photo Fails
Usually
Photo!
Usually
Photo?
Arrest
Imminent
TSB Level, mg/dL (pmol/L)
Severe
Age
hours
>90
>95
>90
MILD
75-90
90-95
81-90
MOD
60-74
85-89
70-80
SEV
<60
<85
<70
12
Guide to
limits of normal pulse in children
Pulse/min
Moderate;
often only
end expiratory
<100
WT FOR HT
Usually not
Parameter
Accessory
muscles and
suprasternal
retractions
Wheeze
Mild
NUTRITION
61
>25 (430)
49-72
>15 (260)
>18 (310)
>25 (430)
>30 (510)
>72
>17 (290)
>20 (340)
>25 (430)
>30 (510)
Phototherapy at these TSB levels is a clinical option, meaning that

the intervention is available and may be used on the basis of individual clinical judgment.
Intensive phototherapy (Appendix) should produce a decline of
TSB of 1 to 2 mg/dL within 4 to 6 hours and the TSB level should
continue to fall and remain below the threshold level for exchange
Moderate
Hyperbilirubinemia: Healthy Term Newborn
Normal rate
<160/min
>20 (340)
2-12 months
1-5 years
6-8 years
>15 (260)
Infants
Pre-school
School age
>12 (210)
bradycardia
25-48
>120
...
100-120
...
Usually Loud
...
Loud
...
Moderate;
often only
end expiratory
<100
<=24
Paradoxical
thoracoabdominal
movement
Absence of
wheeze
Xtrans and
Photo Fails
Usually
Xtrans if
Photo Fails
Usually
Photo!
Usually not
Photo?
Arrest
Imminent
TSB Level, mg/dL (pmol/L)
Severe
Age
hours
>90
>95
>90
MILD
75-90
90-95
81-90
MOD
60-74
85-89
70-80
SEV
<60
<85
<70
12
61
Guide to
limits of normal pulse in children
WT FOR HT
Pulse/min
Parameter
Accessory
muscles and
suprasternal
retractions
Wheeze
Mild
NUTRITION
60
Increased
May be agitated
Sentences
Walking
Mild
Guide to rates of breathing associated with respiratory distress in

awake children
RR
Alertness
Talks in
Breathless
Parameter
< 2 months
2-12 months
1-5 years
6-8 years
Often >30/
min
Usually
agitated
Usually agitated
Increased
Words
At rest
Infant
stops feeding
Severe
Phrases
Talking Infant
softer, shorter
cry; difficulty
feeding; Prefers
sitting
Moderate
Arrest
Imminent
<60/min
<50/min
<40/min
<30/min
Drowsy/confused
SEVERITY OF ASTHMA ATTACKS (GINA Guidelines)
Increased
May be agitated
Sentences
Walking
Mild
Guide to rates of breathing associated with respiratory distress in

awake children
RR
Alertness
Talks in
Breathless
Parameter
< 2 months
2-12 months
1-5 years
6-8 years
Often >30/
min
Usually
agitated
Usually agitated
Increased
Words
At rest
Infant
stops feeding
Severe
Phrases
Talking Infant
softer, shorter
cry; difficulty
feeding; Prefers
sitting
Moderate
Arrest
Imminent
<60/min
<50/min
<40/min
<30/min
Drowsy/confused
SEVERITY OF ASTHMA ATTACKS (GINA Guidelines)
DAILY CALORIC REQUIREMENT
60
13
AGE
Cal/kg
CHON g/kg
0 6 mo
110 115
2.5
7 12
110 115
2.5 3.0
1 3 yr
110
2.0 2.5
46
90 100
2.25
79
80 90
1.5 2.0
10 12
70 80
1.5 2.0
13 15
55 65
1.5
16 19
45 55
1.0 1.5
TCR = Wt x Cal Rqt

CHON = 4 x (g/kg); max 10%
Fats = rest as fats
Catch up: + 50% TCR
13
DAILY CALORIC REQUIREMENT
AGE
Cal/kg
CHON g/kg
0 6 mo
110 115
2.5
7 12
110 115
2.5 3.0
1 3 yr
110
2.0 2.5
46
90 100
2.25
79
80 90
1.5 2.0
10 12
70 80
1.5 2.0
13 15
55 65
1.5
16 19
45 55
1.0 1.5
TCR = Wt x Cal Rqt

CHON = 4 x (g/kg); max 10%
Fats = rest as fats
Catch up: + 50% TCR
RESPIRATORY DISTRESS
CIRCUMSTANCES THAT INCREASE CALORIC

REQUIREMENTS
fever
12% for @ degree above 37
Signs /
0
1
Symptoms
SILVERMAN-ANDERSON RETRACTION SCORING
cardiac failure
15-25%
major surgery
20-30%
burns
upto 100%
severe sepsis
40-50%
Lower chest
long term growth failure
50-100%
Xiphoid
retraction
Nares dilatation
Upper chest
CALORIC REQUIREMENTS ON TOTAL PARENTERAL

NUTRITION
age (yr)
kcal/kg/d
0-1
90-120
1-7 yr
75-90
7-12 yr
60-75
12-18 yr
30-60
2.5-3
infants 0-1 yr
2.5
children 2-13
1.5-2
adolescent
1-1.5
Lag on
inspiration
Just visible
See saw
Just visible
Marked
None
Minimal
Marked
Expiratory grunt
None
PaO--2
Cyanosis
70 100 in
room air
None
Slight
Breath Sounds
Normal
Uneven
Accessory Muscles
Wheezing
None
Moderate
None
Moderate
Marked
<70
< 70 in FiO2
40
Present
Decreased
to normal
Maximal
Extreme to
normal
comatose
Cerebral FuncNormal
Depressed
tion
or agitated
Score > 5 impending respiratory arrest; 6 needs ICU confinement;
paCO2 of 65 respiratory distress or flare
14
59
RESPIRATORY DISTRESS
CIRCUMSTANCES THAT INCREASE CALORIC

REQUIREMENTS
fever
12% for @ degree above 37
Signs /
0
1
Symptoms
SILVERMAN-ANDERSON RETRACTION SCORING
cardiac failure
15-25%
major surgery
20-30%
burns
upto 100%
severe sepsis
40-50%
Lower chest
long term growth failure
50-100%
Xiphoid
retraction
Nares dilatation
Upper chest
CALORIC REQUIREMENTS ON TOTAL PARENTERAL

NUTRITION
age (yr)
kcal/kg/d
0-1
90-120
1-7 yr
75-90
7-12 yr
60-75
12-18 yr
30-60
premature neonates
2.5-3
infants 0-1 yr
2.5
children 2-13
1.5-2
adolescent
1-1.5
Synchronized
No retraction
None
Lag on
inspiration
Just visible
See saw
Just visible
Marked
None
Minimal
Marked
Expiratory grunt
None
PaO--2
Cyanosis
70 100 in
room air
None
Slight
Breath Sounds
Normal
Uneven
Accessory Muscles
Wheezing
None
Moderate
None
Moderate
Marked
Stethoscope
Naked ear
only
RESPIRATORY DIFFICULTY: Grade 0: none; Grade I: moderate;
Grade 2: maximum
ASTHMA WOODS SCORE
AMINO ACID REQUIREMENTS OF PARENTERALLY FED

INFANTS AND CHILDREN
g/kg/d
14
Synchronized
No retraction
None
Stethoscope
Naked ear
only
RESPIRATORY DIFFICULTY: Grade 0: none; Grade I: moderate;
Grade 2: maximum
ASTHMA WOODS SCORE
AMINO ACID REQUIREMENTS OF PARENTERALLY FED

INFANTS AND CHILDREN
g/kg/d
premature neonates
<70
< 70 in FiO2
40
Present
Decreased
to normal
Maximal
Extreme to
normal
comatose
Cerebral FuncNormal
Depressed
tion
or agitated
Score > 5 impending respiratory arrest; 6 needs ICU confinement;
paCO2 of 65 respiratory distress or flare
59
Lactate liver HCO3

Acetate muscle HCO3
Lactate is converted to HCO3
Cell produces acid lactate during metab
LRS Na lactate doesnt cause acidosis
INFLUENZA
Inactivated virus; viral components
IM
-----------------------------------------------MEASLES
Live virus
9 months
SC
-----------------------------------------------MMR
Live virus
12 months 2 y/o
booster at 4-12 y/o
SC
-----------------------------------------------PNEUMOCOCCAL
Polysaccharide
IM or SC
-----------------------------------------------TYPHOID
Parenteral (inactivated virus) SC
Oral (live bacteria)
>5 y/o
booster every 3-5 years
-----------------------------------------------VARICELLA
Live virus
12-18 months
>13 y/o, 2 shots are given
SC
------------------------------------------------
58
USE OF IV FAT (10% SOLUTION)

g/kg/d
PT/
SGA
initial dose
0.5
1g/kg/d
0.25
max dose
older
child
1g/kg/d
5ml/kg/d
10ml/kg/d
0.5g/kg/d
0.5g/kg/d
2.5ml/k/d
5ml/kg/d
4g/kg/d
2g/kg/d
3g/kg/d
4g/kg/d
10ml/kg/d
5ml/kg/d
2g/kg/d
CALORIC REQUIREMENTS ON TOTAL ENTERAL NUTRITION

age (yr)
kcal/kg/d
0-0.5 yr
117
0.5-1
105
1-3 yr
100
4-6 yr
85-90
7-10yr
80-85
11-14 yr
M 60-64
F 48-55
15-18
M 43-49
F 38-40
15
Lactate liver HCO3

Acetate muscle HCO3
Lactate is converted to HCO3
Cell produces acid lactate during metab
LRS Na lactate doesnt cause acidosis
INFLUENZA
Inactivated virus; viral components
IM
-----------------------------------------------MEASLES
Live virus
9 months
SC
-----------------------------------------------MMR
Live virus
12 months 2 y/o
booster at 4-12 y/o
SC
-----------------------------------------------PNEUMOCOCCAL
Polysaccharide
IM or SC
-----------------------------------------------TYPHOID
Parenteral (inactivated virus) SC
Oral (live bacteria)
>5 y/o
booster every 3-5 years
-----------------------------------------------VARICELLA
Live virus
12-18 months
>13 y/o, 2 shots are given
SC
------------------------------------------------
58
increase
daily
dose by
FT/ AGA
USE OF IV FAT (10% SOLUTION)

g/kg/d
PT/
SGA
initial dose
0.5
1g/kg/d
increase
daily
dose by
0.25
max dose
FT/ AGA
older
child
1g/kg/d
5ml/kg/d
10ml/kg/d
0.5g/kg/d
0.5g/kg/d
2.5ml/k/d
5ml/kg/d
4g/kg/d
2g/kg/d
3g/kg/d
4g/kg/d
10ml/kg/d
5ml/kg/d
2g/kg/d
CALORIC REQUIREMENTS ON TOTAL ENTERAL NUTRITION
15
age (yr)
kcal/kg/d
0-0.5 yr
117
0.5-1
105
1-3 yr
100
4-6 yr
85-90
7-10yr
80-85
11-14 yr
M 60-64
F 48-55
15-18
M 43-49
F 38-40
Age
(mos)
wt
gain/
mon
2 lb
growth
(cm/
mo)
3.5
hc cm /
mo
RDA
kcl/k/d
0-3
wt
gain
(g)
30
115
3-6
20
1 1/4 lb
1100
6-9
15
1 lb
1.5
0.5
100
9-12
12
13 oz
1.2
0.5
100
1-3 y
8 oz
0.25
100
4-6 yr
6 oz
3cm/yr
1cm/yr
90-100
LIVER SPAN
Male
1 week old
4.5 - 5.0 cm
12 years old
7.0 8.0 cm
>12 years old
0.032 x wt (lbs) +
0.18 x ht (in) ___
7.86
Female
6.0 6.5 cm
0.027 x wt (lbs) +
0.22 x ht (in)
16
Age
(mos)
57
wt
gain/
mon
2 lb
growth
(cm/
mo)
3.5
hc cm /
mo
RDA
kcl/k/d
0-3
wt
gain
(g)
30
115
3-6
20
1 1/4 lb
1100
6-9
15
1 lb
1.5
0.5
100
9-12
12
13 oz
1.2
0.5
100
1-3 y
8 oz
0.25
100
4-6 yr
6 oz
3cm/yr
1cm/yr
90-100
LIVER SPAN
Male
1 week old
4.5 - 5.0 cm
12 years old
7.0 8.0 cm
>12 years old
0.032 x wt (lbs) +
0.18 x ht (in) ___
7.86
16
BCG
Live bacteria
Birth
0.05 cc right deltoid
0.05 cc left deltoid school-age
ID
-----------------------------------------------DPT
Toxoid and inactivated bacteria
DT-acellular-P (toxoid and bacterial products or fractions)
6,10,14
boosters at 12months 2 years
booster at 4-6 years
Td booster >12 y/o
0.5 cc
IM
-----------------------------------------------Hepa A
>2 y/o
2nd shot 6-12 months after 1st shot
IM
-------------------------------HepB
Yeast or plasma derived recombinant
0,1,6
IM
-----------------------------------------------IPV/OPV
Inactivated/live virus
6,10,14
booster at 4-6 y/o
SC/oral
-----------------------------------------------HIB
6,10,14
booster 12months 2 y/o
IM
BCG
Live bacteria
Birth
0.05 cc right deltoid
0.05 cc left deltoid school-age
ID
-----------------------------------------------DPT
Toxoid and inactivated bacteria
DT-acellular-P (toxoid and bacterial products or fractions)
6,10,14
boosters at 12months 2 years
booster at 4-6 years
Td booster >12 y/o
0.5 cc
IM
-----------------------------------------------Hepa A
>2 y/o
2nd shot 6-12 months after 1st shot
IM
-------------------------------HepB
Yeast or plasma derived recombinant
0,1,6
IM
-----------------------------------------------IPV/OPV
Inactivated/live virus
6,10,14
booster at 4-6 y/o
SC/oral
-----------------------------------------------HIB
6,10,14
booster 12months 2 y/o
IM
Female
6.0 6.5 cm
0.027 x wt (lbs) +
0.22 x ht (in)
57
HEPATITIS PROFILE
BLOOD TRANSFUSION
>may transfuse x cc pRBC properly typed and cross matched to
run for 4 hours
>hold IVF while on BT
>monitor VS q 15 for 1st hour, q30 for 2nd hour and q1 until stable
>BT precutions please
>please give Furosemide 20 mg IV post BT
>Total blood volume = wt(Kg) x 80cc/Kg = ____ cc
> if PPF, give 20 % of total blood
>if PNSS 10%
> = 7Kg=70cc run 70 cc NSS
ex. 7Kg Wt. = 560ccx20% / 112 cc
1.2 hours ;same FFP volume
anti HAV IgM
HbsAg
anti HBC
IgM
acute Hep A
Acute Hep B
r/o other hep
acute Hep A/B
acute hep A/B
REFERRAL
>Px seen and examined
>Will inform service consultant
>PJIIC to do referral notes
>Will follow-up px
>Thank you for the referral.
SCREENING
anti HBS
HbsAg
anti
HBC
prob hep B carrier
prob false (+) test rpt after 6

months
prev exposure to HepB with

recovery

possible recovery
immunity after vaccination
ANAPHYLAXIS
SC or IM
epi 1:1,000 (aqueous): 0.01ml/kg per dose repeated q10-20 min.
usual dose: if infant: 0.05 to 0.1 ml
if children: 0.1 to 0.3 ml
IV
epi 1:1,000 (aqueous): 0.1 cc/kg diluted to 1:10,000 with NSS
dose may be repeated q 10-20 minutes. a continuous infusion
should be started if repeated doses are required (one milligram
(1ml) of 1:1,000 dilution of epinephrine added to 250ml D5W,
resutling in a concentration of 4 ug/ml, infused initially at a rate of
0.1 ug/kg/min, and increased gradually to 1.5 ug/kg/min to
maintain blood pressure)
nebulize with albuterol or IV aminophylline as indicated for
bronchospasm
56
17
HEPATITIS PROFILE
BLOOD TRANSFUSION
>may transfuse x cc pRBC properly typed and cross matched to
run for 4 hours
>hold IVF while on BT
>monitor VS q 15 for 1st hour, q30 for 2nd hour and q1 until stable
>BT precutions please
>please give Furosemide 20 mg IV post BT
>Total blood volume = wt(Kg) x 80cc/Kg = ____ cc
> if PPF, give 20 % of total blood
>if PNSS 10%
> = 7Kg=70cc run 70 cc NSS
ex. 7Kg Wt. = 560ccx20% / 112 cc
1.2 hours ;same FFP volume
anti HAV IgM
HbsAg
anti HBC
IgM
acute Hep A
Acute Hep B
r/o other hep
acute Hep A/B
acute hep A/B
REFERRAL
>Px seen and examined
>Will inform service consultant
>PJIIC to do referral notes
>Will follow-up px
>Thank you for the referral.
SCREENING
anti HBS
HbsAg
anti
HBC
prob hep B carrier
prob false (+) test rpt after 6

months

recovery

possible recovery
immunity after vaccination
ANAPHYLAXIS
SC or IM
epi 1:1,000 (aqueous): 0.01ml/kg per dose repeated q10-20 min.
usual dose: if infant: 0.05 to 0.1 ml
if children: 0.1 to 0.3 ml
IV
epi 1:1,000 (aqueous): 0.1 cc/kg diluted to 1:10,000 with NSS
dose may be repeated q 10-20 minutes. a continuous infusion
should be started if repeated doses are required (one milligram
(1ml) of 1:1,000 dilution of epinephrine added to 250ml D5W,
resutling in a concentration of 4 ug/ml, infused initially at a rate of
0.1 ug/kg/min, and increased gradually to 1.5 ug/kg/min to
maintain blood pressure)
nebulize with albuterol or IV aminophylline as indicated for
bronchospasm
56
17
MOMS S/SX
PPD (+)
Current Dse w tx
DX OF
MOM
TB Infxn
TB Dse
Current Dse w/o tx
TB Dse
Hematogenous
Spread
TB Dse
w/
spread
MGT OF
BABY
BCG
PPD at 4
wks of
age
PPD,
CXR at
once
PPD,
CXR,
AFB of
gastric
aspirate
PTB Relapse
INITIAL TX
RIU D/C
> May go home with mother
> PJIIC to do fundoscopy and provide DS prior to discharge
> Home instructions given (burp, bath, cord care, feeding)
> Ff up at Pedia OPD on next Tuesday for BCG & Hep B
> Milk feeding Q3 hours or per demand, preferably breast feeding
> Daily bath : T 36.5-37.2
> Daily cord care with 70 % isopropyl alcohol 3x/day
> Burping every end- feeding for 20 minutes
S/P BMA
>Please send specimen for the ff: BMA slides = for staining
BMA C/S =
>Maintain patient on prone position x 4 hours
>May have milk feedings/ DAT once fully awake
>Monitor VS q15 min for the 1st hour
q30 min for the 2nd hour
q1 hour thereafter until stable
>watch out for bleeding on BMA site and refer to PROD stat
for LP
>Secure consent for LP
>Prepare the ff materials: LP set
Gloves size 7 #2
Needle, gauge 23
OS, 4x4
Sterile cotton balls
Betadine solution
>NPO now
S/P Lumbar tap
>Hgt now
>Please send specimen as ff: bottle #1 : WBC, diff count
bottle #2 : CSF C/S
bottle #3 : protein, sugar
>Flat on bed for 4 hours
> NPO temporarily
>Montior VS q15 min x 1 hour
q30 min x next hour
None
INH
INH or RIF
HRZS
2HREZS or
1HREZ, 5 HRE
LIVER FXN TESTS

0 5 days
1 19 years
10 19 years
SGPT / ALT
6 50
5 45
SGOT / AST
35 140
15 55
5 - 45
TOTAL BILIRUBIN ( ACTUAL/17.1)

Preterm
Full term
Cord Blood
0 1 day
1 2 days
2 5 days
> 5 days
<2.0
<8.0
<12.0
<16.0
<20.0
<2.0
<6.0
<8.0
<12.0
<10.0
ALBUMIN
Premature
Full term, <6days
< 5 years
5 19 years
1.8 3.0
2.5 3.4
3.9 5.0
4.0 5.3
18
55
MOMS S/SX
PPD (+)
Current Dse w tx
DX OF
MOM
TB Infxn
TB Dse
Current Dse w/o tx
TB Dse
Hematogenous
Spread
TB Dse
w/
spread
MGT OF
BABY
BCG
PPD at 4
wks of
age
PPD,
CXR at
once
PPD,
CXR,
AFB of
gastric
aspirate
PTB Relapse
INITIAL TX
RIU D/C
> May go home with mother
> PJIIC to do fundoscopy and provide DS prior to discharge
> Home instructions given (burp, bath, cord care, feeding)
> Ff up at Pedia OPD on next Tuesday for BCG & Hep B
> Milk feeding Q3 hours or per demand, preferably breast feeding
> Daily bath : T 36.5-37.2
> Daily cord care with 70 % isopropyl alcohol 3x/day
> Burping every end- feeding for 20 minutes
S/P BMA
>Please send specimen for the ff: BMA slides = for staining
BMA C/S =
>Maintain patient on prone position x 4 hours
>May have milk feedings/ DAT once fully awake
>Monitor VS q15 min for the 1st hour
q30 min for the 2nd hour
>watch out for bleeding on BMA site and refer to PROD stat
for LP
>Secure consent for LP
>Prepare the ff materials: LP set
Gloves size 7 #2
Needle, gauge 23
OS, 4x4
Sterile cotton balls
Betadine solution
>NPO now
S/P Lumbar tap
>Hgt now
>Please send specimen as ff: bottle #1 : WBC, diff count
bottle #2 : CSF C/S
bottle #3 : protein, sugar
>Flat on bed for 4 hours
> NPO temporarily
>Montior VS q15 min x 1 hour
q30 min x next hour
None
INH
INH or RIF
HRZS
2HREZS or
1HREZ, 5 HRE
LIVER FXN TESTS

0 5 days
1 19 years
10 19 years
SGPT / ALT
6 50
5 45
SGOT / AST
35 140
15 55
5 - 45
TOTAL BILIRUBIN ( ACTUAL/17.1)

Preterm
Full term
Cord Blood
0 1 day
1 2 days
2 5 days
> 5 days
<2.0
<8.0
<12.0
<16.0
<20.0
<2.0
<6.0
<8.0
<12.0
<10.0
ALBUMIN
Premature
Full term, <6days
< 5 years
5 19 years
18
1.8 3.0
2.5 3.4
3.9 5.0
4.0 5.3
55
GLUCOSE (mg/dL) (0.0555) = mmol/L
WATERLOW CLASSIFICATION
WASTING
>90
80-90
70-79
<70
STUNTING
: normal
: mild
: moderate
: severe
Height in centimeters
ideal height (P50) for age
>95
90-95
80-90
<80
mmol/L
Cord blood
45 96
2.5 5.3
Premature
20 60
1.1 3.3
Neonate
30 60
1.7 3.3
1 day
40 60
2.2 3.3
>1 day
50 90
2.8 5.0
Child
60 100
3.3 5.5
Adult
70 - 105
3.9 5.3
Oral Dose
Adult
75g
Child
1.75gm/kg
(max: 75gm)
OGTT
Normal
Diabetic
Fasting
70 105
> 126
60min
120 170
> 200
90min
100 140
> 200
120min
70 - 120
> 200
x 100%
: normal
: mild
: moderate
: severe
IDEAL WEIGHT
At birth
3000 g
<6 months: weight in g = Age in months x 600 + BW
6-12 months: weight in g = age in months x 500 + BW
1-6 years: 2n + 8
6-12 years = n x 7-5 (7n-5/2)
2
4-5 mos
1 year
2 years
3 years
5 years
7 years
10 years
Mg/dl
Actual weight in kilograms

x 100%
ideal weight (P50) for actual height
2 x BW ~ 6 kg
3 x BW ~ 9 kg
4 x BW ~ 12 kg
5 x BW ~ 15 kg
6 x BW
7 x BW
10 x BW
54
19
GLUCOSE (mg/dL) (0.0555) = mmol/L
WATERLOW CLASSIFICATION
WASTING
>90
80-90
70-79
<70
STUNTING
: normal
: mild
: moderate
: severe
Height in centimeters
ideal height (P50) for age
>95
90-95
80-90
<80
54
mmol/L
Cord blood
45 96
2.5 5.3
Premature
20 60
1.1 3.3
Neonate
30 60
1.7 3.3
1 day
40 60
2.2 3.3
>1 day
50 90
2.8 5.0
Child
60 100
3.3 5.5
Adult
70 - 105
3.9 5.3
Oral Dose
Adult
75g
Child
1.75gm/kg
(max: 75gm)
OGTT
Normal
Diabetic
Fasting
70 105
> 126
60min
120 170
> 200
90min
100 140
> 200
120min
70 - 120
> 200
x 100%
: normal
: mild
: moderate
: severe
IDEAL WEIGHT
At birth
3000 g
<6 months: weight in g = Age in months x 600 + BW
6-12 months: weight in g = age in months x 500 + BW
1-6 years: 2n + 8
6-12 years = n x 7-5 (7n-5/2)
2
4-5 mos
1 year
2 years
3 years
5 years
7 years
10 years
Mg/dl
Actual weight in kilograms

x 100%
ideal weight (P50) for actual height
2 x BW ~ 6 kg
3 x BW ~ 9 kg
4 x BW ~ 12 kg
5 x BW ~ 15 kg
6 x BW
7 x BW
10 x BW
19
20
Cord Blood
0.6 1.2
53 106
Newborn
0.3 1.0
27 88
Infant
0.2 0.4
18 35
Child
0.3 0.7
27 62
Adolescent
0.5 1.0
44 88
Adult male
0.6 1.2
53 106
Adult female
0.5 1.1
44 - 97
20
RENAL FUNCTION
CREATININE CLEARANCE
(ml/min/1.73m2)
97 137
Creatinine Clearance: (140-age) x (wt in kg)

72(M) x serum Cr (mg/dl)
85(F) x serum Cr (mg/dl)
Decreases ~6.5mL/min/decade
88 - 128
Pre-renal
BUN/Crea x 247.62
>20
Renal
Post-renal
<10 -15
CREATININE (mg/dl) (88.4) mmol/L
Cord Blood
0.6 1.2
53 106
Newborn
0.3 1.0
27 88
Infant
0.2 0.4
18 35
Child
0.3 0.7
27 62
Adolescent
0.5 1.0
44 88
Adult male
0.6 1.2
53 106
Adult female
0.5 1.1
44 - 97
53
Social Skills
Social Skills
CREATININE (mg/dl) (88.4) mmol/L
Cooperative
group play;
simple games;
limited verbal
interaction
<10 -15
Play in samesex pairs or

groups; uses
social conventions (please,
thank you);
identifies self
on phone automatically
Post-renal
Problem Solving, Reasoning,

Moral Development
>20
Renal
Cooperative
group play;
simple games;
limited verbal
interaction
<40 years Female

Play in samesex pairs or
groups; uses
social conventions (please,
thank you);
identifies self
on phone automatically
Abstract reasoning skills

developing;
attempt word
problem solving
strategies;
solve 2-step
abstract problems; empathize ; understands rules of
complex games
and anticipate
action (chess,
sports)
Group activities
focus on areas
of competence
or common
social interest;
usual plays in
or group of
same sex
BUN/Crea x 247.62
Compares
volumes; begins to reason;
attampts simple
conceptual
problems;
limited capacity
for empathy;
right or wrong
defined in
terms of punishment; interest in rules of
complex games
Pre-renal
Compares
lengths, sizes,
concrete problem solving;
turns to adult
for answers
Flexible, abstract reasoning skills fullydeveloped;

understands
and discusses
concepts
(liberty, justice,
freedom) and
ideals; right or
wrong defined
in terms of
impact on
individual and
society
Interaction
involves exploration of feelings with
friends; social
activities more
adult-like; peer
approval important; early
sexual relationships emerges
88 - 128
Flexible, abstract reasoning skills fullydeveloped;

understands
and discusses
concepts
(liberty, justice,
freedom) and
ideals; right or
wrong defined
in terms of
impact on
individual and
society
Interaction
involves exploration of feelings with
friends; social
activities more
adult-like; peer
approval important; early
sexual relationships emerges
Creatinine Clearance: (140-age) x (wt in kg)

72(M) x serum Cr (mg/dl)
85(F) x serum Cr (mg/dl)
Decreases ~6.5mL/min/decade
Problem Solving, Reasoning,

Moral Development
<40 years Male
Abstract reasoning skills

developing;
attempt word
problem solving
strategies;
solve 2-step
abstract problems; empathize ; understands rules of
complex games
and anticipate
action (chess,
sports)
Group activities
focus on areas
of competence
or common
social interest;
usual plays in
or group of
same sex
<40 years Female
Compares
volumes; begins to reason;
attampts simple
conceptual
problems;
limited capacity
for empathy;
right or wrong
defined in
terms of punishment; interest in rules of
complex games
<40 years Male

CREATININE CLEARANCE
(ml/min/1.73m2)
97 137
Compares
lengths, sizes,
concrete problem solving;
turns to adult
for answers
RENAL FUNCTION
53
52
Visuospatial
and Perceptual
Skills
Expressive
Language
Skills
AGE
Changes style
of language to
top fit several
contexts
(formal and
informal) and
listener (peer
vs principal or
parent)
Attempts 3dimensional
shapes in
artwork; copies
complex figures; begins to
understand
maps, geography, good right
word vocabu-
7-9 years
Uses temporal
propositions
(before, after)
ises past and
future tenses;
narrative has
proper sequence development and
No reversals of
b and d persists; copies
right word;
vocabulary
increases
Sentences
average 6
words in length;
uses noun
plurals and
possesives,
narrative has
cause-effect
sequence.
Matches identical shapes or

figures; copies,
discriminates
left vs right
consistently
10-12 years
PT
NB
5-6 years
Understands
architectural
plans, complex
spatial relationships; artwork
matures; uses
and creates
maps; schematic drawing
of circuits,
Complex sentence structure;

uses idiomatic
language; can
speak and
write about
abstract concepts
13+ years
52
Visuospatial
and Perceptual
Skills
Expressive
Language
Skills
AGE
Changes style
of language to
top fit several
contexts
(formal and
informal) and
listener (peer
vs principal or
parent)
Attempts 3dimensional
shapes in
artwork; copies
complex figures; begins to
understand
maps, geography, good right
word vocabu-
7-9 years
Uses temporal
propositions
(before, after)
ises past and
future tenses;
narrative has
proper sequence development and
No reversals of
b and d persists; copies
right word;
vocabulary
increases
Sentences
average 6
words in length;
uses noun
plurals and
possesives,
narrative has
cause-effect
sequence.
Matches identical shapes or
figures; copies,
discriminates
left vs right
consistently
10-12 years
PT
NB
5-6 years
Understands
architectural
plans, complex
spatial relationships; artwork
matures; uses
and creates
maps; schematic drawing
of circuits,
Complex sentence structure;

uses idiomatic
language; can
speak and
write about
abstract concepts
13+ years
BUN (mg/dl) (0.357) = mmol/L
21
mg/dL
mmol/L
Cord Blood
21 40
7.5 14.3
Premature
3 25
1.1 9.0
Newborn
3 12
1.1 4.3
Infant/ Child
5 18
1.8 6.4
Thereafter
7 - 18
2.5 6.4
CSF
Cell count (cells/mm3)
0 25MN
0 25
0 10 PMNs
0 10
0 1000RBC
0 - 1000
Neonate
Neonate
0 20 MNs
X 106 cells /L
0 20 MNs
0 20
0 10 PMNs
0 10
0 800 RBC
0 - 800
0 5 MN
05
0 10 PMNs
0 10
0 50 RBC
0 - 50
21
BUN (mg/dl) (0.357) = mmol/L

mg/dL
mmol/L
Cord Blood
21 40
7.5 14.3
Premature
3 25
1.1 9.0
Newborn
3 12
1.1 4.3
Infant/ Child
5 18
1.8 6.4
Thereafter
7 - 18
2.5 6.4
CSF
Cell count (cells/mm3)
0 25MN
0 25
0 10 PMNs
0 10
0 1000RBC
0 - 1000
X 106 cells /L
0 20
0 10 PMNs
0 10
0 800 RBC
0 - 800
0 5 MN
05
0 10 PMNs
0 10
0 50 RBC
0 - 50
22
Adult 100 - 160
CSF Glucose
Traumatic Tap
1 mg CHON = 80 1000 RBC
1 WBC = 60 1000 RBC
Correction Factor
700 RBC = 1 WBC
500 700 RBC = 1 mg% CHON
22
CSF (Leukocyte Diff. Count %)
Lymphocytes
62 + 34
Monocytes
36 + 20
Neutrophils
2+5
Histiocytes
0 (rare)
Ependymal cells
0 (rare)
Eosinophils
0 (rare)
CSF Pressure
CSF Volume
CSF Glucose
70 180 mmH2O
Child 60 100
Adult 100 - 160
Traumatic Tap
1 mg CHON = 80 1000 RBC
1 WBC = 60 1000 RBC
Correction Factor
700 RBC = 1 WBC
500 700 RBC = 1 mg% CHON
51
Receptic Language Skills
Child 60 100
Receptic Language Skills
70 180 mmH2O
Understands
where,
when, why
questions
Understands
passive verb
(the car was hit
by the train)
0 (rare)
Understands
linguistic explanations of
abstract concepts; appreciates deep
structure
humor
Eosinophils
Understands
multiple meaning of words;
knows meaning
of figurative
language
(simile, analogy
metaphor,)
0 (rare)
Adult 40 70mg/dL
Understands
passive verb
(the car was hit
by the train)
Ependymal cells
Understands
where,
when, why
questions
CSF Volume
Sequential
Concepts
0 (rare)
Understands
multiple meaning of words;
knows meaning
of figurative
language
(simile, analogy
metaphor,)
Understands
linguistic explanations of
abstract concepts; appreciates deep
structure
humor
Remembers 67 digits or
objects in
sequence;
performs multistep tasks or
problems; write
organized
essay with
appropriate
introduction,
development
Histiocytes
Remembers 6
digits or objects
in sequence;
knows months
of year, can
alphabetize
automatically,
to use telephone, book,
dictionary, card
catalogue
2+5
Remembers 5
digits or objects
in sequence;
uses before
and after correctly; copunts
backwards 201; knows days
of week backward; tells time
to the minute
on analogue
Neutrophils
Sequential
Concepts
CSF Pressure
Remembers 4digits or objects

in sequence;
knows past and
future tenses;
knows alphabet, days of
week in order;
count to >20
36 + 20
Remembers 67 digits or
objects in
sequence;
performs multistep tasks or
problems; write
organized
essay with
appropriate
introduction,
development
Monocytes
Remembers 6
digits or objects
in sequence;
knows months
of year, can
alphabetize
automatically,
to use telephone, book,
dictionary, card
catalogue
62 + 34
Remembers 5
digits or objects
in sequence;
uses before
and after correctly; copunts
backwards 201; knows days
of week backward; tells time
to the minute
on analogue
Lymphocytes
Remembers 4digits or objects

in sequence;
knows past and
future tenses;
knows alphabet, days of
week in order;
count to >20
CSF (Leukocyte Diff. Count %)
Adult 40 70mg/dL
51
50
Fine Motor Skill
Gross Motor
Skill
AGE
Pencil grasp
becomes sure;
capital letter
formations
automatic;
colors neatly
with crayons
Can walk on
heels or toes
Hops on 1 foot;
5-6 years
10-12 years
Involvement in
sports increases; good
eye-hand coordination; more
strength
Cursive writing
becomes automatic; works
well with tools
and implements; can do
complex crafts,
mechanical or
art projects
7-9 years
Secure balance
during stressed
gait; begins to
learn complex
motor tasks,
sports
Prints capital
and lower case
letters neatly;
improved pancil
control; uses
tools awkwardly
DEVELOPMENTAL ATTAINMENT (5-19)
Writes or types
with ease; can
work with small
parts and tools;
build difficult
models; increased refinement of crafts,
artwork
Much increased
strenth, endurance, coordination
13+ years
50
Fine Motor Skill
Gross Motor
Skill
AGE
Pencil grasp
becomes sure;
capital letter
formations
automatic;
colors neatly
with crayons
Can walk on
heels or toes
Hops on 1 foot;
5-6 years
10-12 years
Involvement in
sports increases; good
eye-hand coordination; more
strength
Cursive writing
becomes automatic; works
well with tools
and implements; can do
complex crafts,
mechanical or
art projects
7-9 years
Secure balance
during stressed
gait; begins to
learn complex
motor tasks,
sports
Prints capital
and lower case
letters neatly;
improved pancil
control; uses
tools awkwardly
DEVELOPMENTAL ATTAINMENT (5-19)
Writes or types
with ease; can
work with small
parts and tools;
build difficult
models; increased refinement of crafts,
artwork
Much increased
strenth, endurance, coordination
13+ years
BLOOD
2 days
2 months
6-12 years
Male
Female
BLOOD
2 days
2 months
6-12 years
Male
Female
Birth
23
Hgb
Birth
Hct
1 day
48 69
3 days
14.5 - 22.5
48 75
12-18 years
9.0 - 14.0
11.5 - 15.5
44 72
28 72
35 45
Male
13.0 16.0
37 49
Female
13.5 17.5
18-49 years
36 46
12.0 16.0
41 53
Hemoconcentration: 3Hgb Hct / 3Hgb x 100
36 - 46
WBC COUNT (x1000 cells/mm3)
24 hours
9.0 30.0
9.4 34.0
1 month
5.0 19.5
1-3 years
6.0 17.5
4-7 years
5.5 15.5
8-13 years
4.5 13.5
Adult
ANC: WBC x Neutrophils = X

N>1,500
<1000 signifies predisposition to infection
4.5 11.0
23
Hgb
Hct
1 day
48 69
3 days
14.5 - 22.5
48 75
12-18 years
9.0 - 14.0
11.5 - 15.5
44 72
28 72
35 45
Male
13.0 16.0
37 49
Female
13.5 17.5
18-49 years
36 46
12.0 16.0
41 53
Hemoconcentration: 3Hgb Hct / 3Hgb x 100

36 - 46
WBC COUNT (x1000 cells/mm3)
24 hours
9.0 30.0
9.4 34.0
1 month
5.0 19.5
1-3 years
6.0 17.5
4-7 years
5.5 15.5
8-13 years
4.5 13.5
Adult
ANC: WBC x Neutrophils = X

N>1,500
<1000 signifies predisposition to infection
4.5 11.0
24
54 62
Lymphocytes
25 33
Monocytes
34
Eosinophils
13
Basophils
0 0.75
Newborn
Adult
CRP < 6
Band to Neutro: Stabs + Mono
Neutro
Normal: < 0.02
84 478
150 - 400
IT: Stabs + Mono N<0.2

Total WBC
ANC: WBC x Segs
49
Backward heel to
toe walk
Skips, both feet
Writes fairly well
Adds and subtracts
Draws complete
person with clothing
Right & Left
Distingushes
Prints first name
Writes alphabet
Counts to 10
Copies square
PLATELET COUNT
6 yrs
Neutrophils segmenters
Heel to toe walk
35
5 yrs
Neutrophils - bands
Recognizes 3 or
more colors
Draws man with 3

parts
Myelocytes
Catches ball well
Dresses self
completely
Tells stories
Can use a knife
Dresses without
supervision
24
4 yrs
IT: Stabs + Mono N<0.2

Total WBC
ANC: WBC x Segs
6 yrs
5 yrs
4 yrs
Backward heel to
toe walk
Skips, both feet
Heel to toe walk
Catches ball well
Hops on 1 foot
150 - 400
Tells tall tales
84 478
Writes fairly well
Draws complete
person with clothing
Writes alphabet
Copies square
Draws man with 3

parts
Imitates cross
PLATELET COUNT
Hops on 1 foot
CRP < 6
Band to Neutro: Stabs + Mono
Neutro
Normal: < 0.02
4 yrs
Adult
Imitates cross
0 0.75
4 yrs
13
Downstairs, 1 foot
per step
Eosinophils
Buttons up
34
Comprehends
prepositions and
words (i.e cold,
tired, hungry)
Recognizes a
color
Monocytes
Downstairs, 1 foot
per step
Newborn
3 yrs
25 33
Separates from
mother easily
Lymphocytes
Counts to 3, or
more
54 62
Right & Left
Distingushes
Adds and subtracts
Prints first name
Counts to 10
Recognizes 3 or
more colors
Comprehends
prepositions and
words (i.e cold,
tired, hungry)
Recognizes a
color
Counts to 3, or
more
Dresses self
completely
Tells stories
Can use a knife
Dresses without
supervision
Tells tall tales
Buttons up
Separates from
mother easily
Dresses with
supervision
Neutrophils segmenters
Gives full name,

sex
35
3 yrs
Basophils
Stands on 1 foot
for 5 secs
Upstairs 1 foot
per step; down; 2
feet per step
Neutrophils - bands
Dresses with
supervision
Gives full name,

sex
Myelocytes
Stands on 1 foot
for 5 secs
Upstairs 1 foot
per step; down; 2
feet per step
LEUKOCYTE DIFFERENTIALS %
49
LEUKOCYTE DIFFERENTIALS %
48
3 years
2 yrs
2 yrs
18 ms
Walks well alone
15 ms
1 ft momentarily
Rides tricycle
Throws ball
Jumps
Up, down stairs

alone
Runs well
Seats self in
childs chair
Creeps upstairs
Walks backward
GROSS MOTOR
AGE
Imitates a circle
Imitates a circular
stroke
Imitates a vertical
stroke
Drinks from cup
FINE MOTOR
little stories
interactive games
Toilet-trained by
day
Uses spoon with
little spilling
Helps in simple
house tasks
Dry by night
Washes and
dries hands
Points to 1 body
part
Follows directions
(2of3)
Names one picture
Uses plurals
Removes garment
Turns pages 2 or
3 at a time
Combine 2 or 3
words in sen-
Indicates need
Imitates housework, sweeping,
Pats pictures
3 words other
than Mama, Dada
10 words
PERSONAL
SOCIAL
LANGUAGE
48
3 years
2 yrs
2 yrs
18 ms
Walks well alone
15 ms
1 ft momentarily
Rides tricycle
Throws ball
Jumps
Up, down stairs

alone
Runs well
Seats self in
childs chair
Creeps upstairs
Walks backward
GROSS MOTOR
AGE
Imitates a circle
Imitates a circular
stroke
Imitates a vertical
stroke
Drinks from cup
FINE MOTOR
little stories
interactive games
Toilet-trained by
day
Uses spoon with
little spilling
Helps in simple
house tasks
Dry by night
Washes and
dries hands
Points to 1 body
part
Follows directions
(2of3)
Names one picture
Uses plurals
Removes garment
Turns pages 2 or
3 at a time
Combine 2 or 3
words in sen-
Indicates need
Imitates housework, sweeping,
Pats pictures
3 words other
than Mama, Dada
10 words
PERSONAL
SOCIAL
LANGUAGE
ESR
Child
Adult male <50
Adult female <50
Newborn
Infants
0-6 mos
3yrs
5 yrs
10 yrs
15 yrs
Newborn
Infants
0-6 mos
3yrs
5 yrs
10 yrs
15 yrs
25
0 10
0 15
0 - 20
ASO TITER (Todd Limits)
2 5 years
6 9 years
10 12 years
120 160
240
320
BLEEDING TIME (minutes)
Normal
Borderline
27
7 - 11
PROTHROMBIN TIME
11 19
11 - 15
APTT (sec)
20 35
<90
SYSTOLIC
DIASTOLIC
p50-p95
80-100
95-112
97-115
116-138
116-138
p50-p95
45-60
64-80
65-84
70-92
70-95
25
ESR
Child
Adult male <50
Adult female <50
0 10
0 15
0 - 20
ASO TITER (Todd Limits)
2 5 years
6 9 years
10 12 years
120 160
240
320
BLEEDING TIME (minutes)
Normal
Borderline
27
7 - 11
PROTHROMBIN TIME
11 19
11 - 15
APTT (sec)
20 35
<90
SYSTOLIC
DIASTOLIC
p50-p95
80-100
95-112
97-115
116-138
116-138
p50-p95
45-60
64-80
65-84
70-92
70-95
Cooperates in
dressing
Attempts to use
a spoon
Attempts to use
a spoon
Obeys commands or requests
11 months
12 months
Stands alone
Walks holding
on
Throws toys
1 word other
than Mama,
Dada
2 words with
meaning
Bangs objects
together
Obeys commands or requests
Helps dress,
holding arm or
foot out
Helps dress,
holding arm or
foot out
2 words with
meaning
Understands
gestures
Does nursery
games
Waves bye-bye
47
Cooperates in
dressing
1 word other
than Mama,
Dada
Throws toys
Stands alone
wt x 5 x desired dose 1 cc/h
Does nursery
games
Waves bye-bye
12 months
shock, renal perf
26
Bangs objects
together
200/250 premx
400/250 premx
Walks holding
on
2.5-5 ug/k/min
inc in 5-10 ug
increments
250/250 premx
500/250 premx
250x20ml vial
11 months
100/1x10 amp
10 months
Wt x 200
100
Infusion rate: 2.515 ug/k/min
clear line of drugs

that will ppt HCO3
Understands
gestures
Dopamine
1/1 amp
9 months
Inotropic support
0.01-0.03 mkds
10 20 ug/kg
min dose:100ug
10 120 mk
Stands holding
on
ER DRUGS
Atropine
Asystole, Bradycardia
CaCl2
hypoten, bradyc
Ca ChB ovrds
Ca Gluconate
hypocal, tetany
Dobutamine
Thumb-finger
grasp
96 104
97 110
98 - 106
Pulls self to
stand
Cord Blood
Newborn
Thereafter
Imitates sound
3.0 7.0
3.5 6.0
3.5 5.0
CHLORIDE (mmol/L)
Holds bottle
<2months
2-12 months
>12 months
134 146
139 146
138 145
136 146
POTASSIUM (mmol/L)
Shy with strangers
47
SODIUM (mmol/L)
Newborn
Infant
Child
Thereafter
(pat-a-cake)

26
10 months
shock, renal perf
(pat-a-cake)
200/250 premx
400/250 premx
Thumb-finger
grasp
2.5-5 ug/k/min
inc in 5-10 ug
increments
250/250 premx
500/250 premx
250x20ml vial
Pulls self to
stand
100/1x10 amp
9 months
Wt x 200
100
Infusion rate: 2.515 ug/k/min
clear line of drugs

that will ppt HCO3
Index finger
approach
Dopamine
1/1 amp
Creeps
Inotropic support
0.01-0.03 mkds
10 20 ug/kg
min dose:100ug
10 120 mk
Stands holding
on
ER DRUGS
Atropine
Asystole, Bradycardia
CaCl2
hypoten, bradyc
Ca ChB ovrds
Ca Gluconate
hypocal, tetany
Dobutamine
Index finger
approach
96 104
97 110
98 - 106
Creeps
Cord Blood
Newborn
Thereafter
Imitates sound
3.0 7.0
3.5 6.0
3.5 5.0
CHLORIDE (mmol/L)
Holds bottle
<2months
2-12 months
>12 months
134 146
139 146
138 145
136 146
POTASSIUM (mmol/L)
Shy with strangers
SODIUM (mmol/L)
Newborn
Infant
Child
Thereafter
Close open
hand movement
Bradycardia, asystole, hypotension,

anaphylaxis
Asthma: 0.3-0.5 ml
of 1:1000 dil
10-100ug/k, then
drip 0.05-2 ug/k/
min
Transfers objects from hand

to hand
250 500 mk
1 2 ml/kg
of D25W
crenation:
infusion
Hydralazine
Art sm ms dilator
0.1 2 mg/k
20/2 amp
Insulin
0.1 u/kg
hgt > 300 mg/dl
Humulin R
Bounces
8 months
7 months
6 months
5 months
AGE
2 meqs/mlx20
1 meq/mg
1g/250ml Inj
Ven dysrhythmias
1 mg/k load, then

drip at
20-50 ug/k/min
Midazolam
0.04 0.1 mk
1/1,5/1,5/5,
15/3 amp
15 tab
NaHCO3
metab acidosis
0.5-1.0 meq/kg
625 mg 7.7 meq
325 mg 3.9 meq
Naloxone
opiate poisoning
10 25 ug/k
8.4% amp x10
0.4/1 inj
0.02/1 neon inj
Epinephrine
Bradycardia, asystole, hypotension,
anaphylaxis
Asthma: 0.3-0.5 ml
of 1:1000 dil
10-100ug/k, then
drip 0.05-2 ug/k/
min
0.1+ 0.9ml
1+ 9ml
Transfers objects from hand

to hand
Glucose
Hypoglycemia,
stupor, seizures
250 500 mk
1 2 ml/kg
of D25W
crenation:
infusion
Hydralazine
Art sm ms dilator
0.1 2 mg/k
20/2 amp
Insulin
0.1 u/kg
hgt > 300 mg/dl
Humulin R
Lidocaine
Bounces
8 months
7 months
6 months
1:1T
1:10T
1 cc/hr = 0.1ug/kg/hr
10cc/h = 1ug/kg/hr
27
rapid
2 meqs/mlx20
1 meq/mg
1g/250ml Inj
Ven dysrhythmias
1 mg/k load, then

drip at
20-50 ug/k/min
Midazolam
0.04 0.1 mk
1/1,5/1,5/5,
15/3 amp
15 tab
seizures, sedation
5 months
1/1 amp
wt x 0.6 + 100cc D5W
Mama, Dada
Plays peek-aboo
Close open
hand movement
ER DRUGS CONT.
KCl
hypokalemia
Sits without
support
Rakes at small
objects
Bears some
weight on legs
Sits with support
Chews
No head lag
Good head
control
Reaches for
objects
Mam when
crying
Recognizes
familiar faces
Feeds self with

crackers
Indicates like,
dislikes
Turns to sound
PERSONAL
SOCIAL
rapid
27
LANGUAGE
FINE MOTOR
GROSS
MOTOR
0.1+ 0.9ml
1+ 9ml
Glucose
Hypoglycemia,
stupor, seizures
Lidocaine
46
AGE
1:1T
1:10T
10cc/h = 1ug/kg/hr
seizures, sedation
46
1/1 amp
wt x 0.6 + 100cc D5W
Mama, Dada
Plays peek-aboo
Epinephrine
KCl
hypokalemia
Sits without
support
Rakes at small
objects
Bears some
weight on legs
Sits with support
Chews
No head lag
Good head
control
Reaches for
objects
Mam when
crying
Recognizes
familiar faces
Feeds self with

crackers
Indicates like,
dislikes
Turns to sound
PERSONAL
SOCIAL
LANGUAGE
FINE MOTOR
GROSS
MOTOR
ER DRUGS CONT.
NaHCO3
metab acidosis
0.5-1.0 meq/kg
625 mg 7.7 meq
325 mg 3.9 meq
Naloxone
opiate poisoning
10 25 ug/k
8.4% amp x10
0.4/1 inj
0.02/1 neon inj
Plays with rattle

in hand
Moves head
towards sound
Grasps object
placed in hand
Chest up, arm
support
Rolls over
Regards hand
Squeals
Laughs
Eye follows
object past
midline
Head control
45 in prone
Hands no
longer fisted
Head control
90 in prone
Head control
45 in prone
Hands no
longer fisted
Head control
90 in prone
Hands together
Responsive,
diminishes
activity when
talked to
Smiles
Throaty gurgling
sounds
Eye follows
object to midline
LANGUAGE
3 months
Regards hand
4 months
2 months
Responsive,
diminishes
activity when
talked to
Plays with rattle

in hand
Moves head
towards sound
Chest up, arm
support
Squeals
Hands together
Grasps object
placed in hand
Rolls over
Laughs
Eye follows
object to midline
Eye follows
object past
midline
Throaty gurgling
sounds
Smiles
PERSONAL
SOCIAL
45
4 months
25, 50, 100 tab

BID
3 months
5, 10 cap
2 months
1 3 mkday
LD
3
MD 1 2
28
Hands fisted
Spironolactone
(Aldactone)
K Sparing Diuretic
Raises head
slightly from
Nifedipine
(Calcibloc)
mkd x 5 = cc of
20% mannitol
0.05 0.1
mkdose SL
20/100ml
(20% vol)
cerebral edema; max
of 2 weeks than use
K+ sparing
1 month
Osmotic Diuretic
LD 1g/kg
MD 0.25 0.5
mkdose q6h
New born
Furosemide
(Lasix, Frusema)
Loop Diuretic
Mannitol
AGE
Doses taken in 24h
0.5 1 mkdose
25 tab
max: 6 mkd
LD 0.02 - 0.04
MD 0.0035 - 0.0075 q12 IV
MD 0.004 x wt mkdose
Rapid LD: >10y: 750-1500 ug, single dose
Slow LD: >10y250-750 ug daily x 1wk
Oral LD: 5-10y
25ug/kg
2- 5y
35ug/kg
FT neon - 2y
45ug/kg
PT neon 1.5-2.5 kg 30ug/kg
<1.5 kg
25ug/kg
Oral MD: 125-750 ug/day
IV LD: 5-10y
25 ug/kg
2- 5y
35 ug/kg
FT 2y
35 ug/kg
PT 1.5-2.5kg
30ug/kg
<1.5
20ug/kg
0.5 1 mkdose
20, 40 tab
20/2 amp
SCREENING BEHAVIOR INVENTORY
IV dose is 75% of
oral dose
FINE MOTOR
45
ANTIHYPERTENSIVES / CARDIAC DRUGS

Acetazolamide
5 10 mkdose
250 tab
(Diamox)
0.25 tab/amp
0.05 mg/ml elixir
Hands fisted
25, 50, 100 tab

BID
28
Captopril (Capoten)
ACE Inhibitor
Digoxin
(Lanoxin)
Raises head
slightly from
1 3 mkday
LD
3
MD 1 2
1 month
Spironolactone
(Aldactone)
K Sparing Diuretic
5, 10 cap
New born
Nifedipine
(Calcibloc)
mkd x 5 = cc of
20% mannitol
0.05 0.1
mkdose SL
20/100ml
(20% vol)
cerebral edema; max
of 2 weeks than use
K+ sparing
GROSS
MOTOR
Tonic neck
reflex
Startles (Moro
reflex)
Osmotic Diuretic
LD 1g/kg
MD 0.25 0.5
mkdose q6h
AGE
Furosemide
(Lasix, Frusema)
Loop Diuretic
Mannitol
LANGUAGE
Doses taken in 24h
FINE MOTOR
IV dose is 75% of
oral dose
GROSS
MOTOR
Tonic neck
reflex
Startles (Moro
reflex)
0.25 tab/amp
0.05 mg/ml elixir
0.5 1 mkdose
25 tab
max: 6 mkd
LD 0.02 - 0.04
MD 0.0035 - 0.0075 q12 IV
MD 0.004 x wt mkdose
Rapid LD: >10y: 750-1500 ug, single dose
Slow LD: >10y250-750 ug daily x 1wk
Oral LD: 5-10y
25ug/kg
2- 5y
35ug/kg
FT neon - 2y
45ug/kg
PT neon 1.5-2.5 kg 30ug/kg
<1.5 kg
25ug/kg
Oral MD: 125-750 ug/day
IV LD: 5-10y
25 ug/kg
2- 5y
35 ug/kg
FT 2y
35 ug/kg
PT 1.5-2.5kg
30ug/kg
<1.5
20ug/kg
0.5 1 mkdose
20, 40 tab
20/2 amp
SCREENING BEHAVIOR INVENTORY
Captopril (Capoten)
ACE Inhibitor
Digoxin
(Lanoxin)
PERSONAL
SOCIAL
ANTIHYPERTENSIVES / CARDIAC DRUGS

Acetazolamide
5 10 mkdose
250 tab
(Diamox)
EENT/Derma Preparations
Fluocinolone
+
Neomycin + Polymyxin
(Aplosyn Otic)
Docusate Na
(Otosol)
3 4 gtts BID QID
H2O2
otitis externa, acute/chronic w or w/o otitis

media
fill ear canal x 4 5 mins, plug, x 2 nights,
suction impacted cerumen
CI: perforated TM
2 3 gtts x 3 days impacted ceru
Ofloxacin
(Inoflox Otic)
3 5 gtts BID
otitis media
JBS lid scrub
cotton swab BID

chalazion, hordeolum
Fucidic Acid
(Fucithalmic)
1 gtt BID x 2 days (1% eye drops)

conjunctivitis, removal of forgn body
Solcoseryl
Paste
Dental
Amoxicillin
(Amoxil, Pediamox)
Orofar L
1 2 lozenges q3 4
15 ml soln gargle x 30 60 mins
Hexetidine
(Bactidol)
mouthful gargle x 30 secs

sorethroat, halitosis
Silver Sulfadiazine
1% cream for burns

(Flammazine)
Mupirocin
(Bactroban)
2% cream / ointment
TID x 10d
Kwell Lotion
Apply all over the body nmt 24, then rinse

x 3d for scabies
44
Sultamicillin
(Unasyn Oral)
Ticarcillin-Clavulanic
Acid (Timentin)
250, 500 cap

125/5 syr, 250/5 forte
100/1; 125/1.25 drops
500 vial
50 100 q6
250, 500 cap
125, 250/5 susp
< 2wks old,
100/1 drops
give q12
250, 500 vial
375 mg (250/125) vial
750 mg (500/250), 1.5 g (1g/500)
50 100T
50T tab
100 200
1.2, 2.4 MU inj
(high dose)
30 50 (Clavulanic Acid)
375, 625, 1g tab
156.25 (125) ,228.5 (200), 312.5 (250),
457/5 (400) susp A
(bid 228/457)
125, 250/5 susp N
300, 600, 1.2 vial
50 100 QID
125, 250/5 susp
250, 500 cap
50 100 QID
250, 500 vial
drip
200 400 (Piperacillin) q6 q8
50 100 (preterms)
2.25g (2g/250mg) vial
4.5g (4g/500mg) vial, IV Infusion ( )ANST;
50 100 PO
125/5 - 200T u
QID
250/5 - 400T u
625/5 -1.2M u
50 100 BID
375, 750 tab
250/5 susp
75 100 q8
1.6g vial: 1.5/100
q12 mkdose
3.2g vial: 5/2
Amoxicillin
(Amoxil, Pediamox)
PENICILLINS
50 100 IV
30 50 PO
Ampicillin
Ampicillin-Sulbactam
(Unasyn) BID
Benzathin Pen G
q6
Co-Amoxiclav
(Augmentin,
Natravox)
apply 3 5 times daily

gingivitis, stomatitis
Cloxacillin Na
(Prostaphlin A)
Oxacillin Na
(Prostaphlin)
PiperacillinTazobactam
(Tazocin)
PhenoxymethylPen
(Sumapen)
29
EENT/Derma Preparations
Fluocinolone
+
Neomycin + Polymyxin
(Aplosyn Otic)
Docusate Na
(Otosol)
3 4 gtts BID QID
H2O2
otitis externa, acute/chronic w or w/o otitis

media
fill ear canal x 4 5 mins, plug, x 2 nights,
suction impacted cerumen
CI: perforated TM
2 3 gtts x 3 days impacted ceru
Ofloxacin
(Inoflox Otic)
3 5 gtts BID
otitis media
JBS lid scrub
cotton swab BID

chalazion, hordeolum
Fucidic Acid
(Fucithalmic)
1 gtt BID x 2 days (1% eye drops)

conjunctivitis, removal of forgn body
Solcoseryl
Paste
Dental
Ampicillin
Ampicillin-Sulbactam
(Unasyn) BID
Benzathin Pen G
q6
Co-Amoxiclav
(Augmentin,
Natravox)
apply 3 5 times daily

gingivitis, stomatitis
Orofar L
1 2 lozenges q3 4
15 ml soln gargle x 30 60 mins
Hexetidine
(Bactidol)
mouthful gargle x 30 secs

sorethroat, halitosis
Silver Sulfadiazine
1% cream for burns

(Flammazine)
Mupirocin
(Bactroban)
2% cream / ointment
TID x 10d
Kwell Lotion
Apply all over the body nmt 24, then rinse

x 3d for scabies
44
PENICILLINS
50 100 IV
30 50 PO
Cloxacillin Na
(Prostaphlin A)
Oxacillin Na
(Prostaphlin)
PiperacillinTazobactam
(Tazocin)
PhenoxymethylPen
(Sumapen)
Sultamicillin
(Unasyn Oral)
Ticarcillin-Clavulanic
Acid (Timentin)
29
250, 500 cap

125/5 syr, 250/5 forte
100/1; 125/1.25 drops
500 vial
50 100 q6
250, 500 cap
125, 250/5 susp
< 2wks old,
100/1 drops
give q12
250, 500 vial
375 mg (250/125) vial
750 mg (500/250), 1.5 g (1g/500)
50 100T
50T tab
100 200
1.2, 2.4 MU inj
(high dose)
30 50 (Clavulanic Acid)
375, 625, 1g tab
156.25 (125) ,228.5 (200), 312.5 (250),
457/5 (400) susp A
(bid 228/457)
125, 250/5 susp N
300, 600, 1.2 vial
50 100 QID
125, 250/5 susp
250, 500 cap
50 100 QID
250, 500 vial
drip
200 400 (Piperacillin) q6 q8
50 100 (preterms)
2.25g (2g/250mg) vial
4.5g (4g/500mg) vial, IV Infusion ( )ANST;
50 100 PO
125/5 - 200T u
QID
250/5 - 400T u
625/5 -1.2M u
50 100 BID
375, 750 tab
250/5 susp
75 100 q8
1.6g vial: 1.5/100
q12 mkdose
3.2g vial: 5/2
CEPHALOSPORINS
Cefalexin 1
(Ceporex)
25 50
Cefoxitin 1
(Panafox)
Cefaclor 2
(Ceclor,
Xelent)
Cefuroxime 2
(Zinacef,
Zinnat,
Panaxim)
Cefixime 3
(Tergecef,
Ultraxime)
80 160 q6 slow IV
Ceftazidime 3
(Fortum,
Zeptrigen)
Ceftriaxone 3
(Forgram,
Rocephin)
Cefotaxime 3
30 50 q8
20 40 TID
50 100 q8
5 10 mkdose BID
50 100 q24
100 meningitic
q12 24
50 100 q6
MVT / ASCORBIC ACID

250, 500, 1g cap
125, 250/5 susp
125/1.25, 100/1 d
1g vial IV
Ceelin
7 12y
2 6y
2 tsp
1 tsp
1 2y
3 12m
<3m
> 15y
4 15y
1.2 ml
0.6 ml
0.3 ml
2 tsp
1 tsp
1 2y
3 12m
<3m
6 12y
2 6y
1.2 ml
0.6 ml
0.3 ml
2 tsp
1 tsp
6 24m
<6m
YA children
Ychild infants
0.6 ml
0.3 ml
2.5 5 ml
0.5 1 ml
Vitamin A
<2y
>2y
100T u
200T u
Tiki-Tiki Plus
<1 y
Tiki-Tiki Star
Adults
4 12y
1 3y
6 12y
1 6y
2 tsp
1 tsp
tsp
1 tsp
tsp
<1y
0.3 ml
100/5 syr
100/1 drops
250 X, 500 cap

125, 250/5 susp
50/1 drops
250, 500 tab
125, 250/5 susp
250, 750, 1.5 inj
750 monovial
100, 200 cap
50mg/gx6g sach
100/5 susp
20/1 drops
250, 500, 1g IV
250, 500, 1g IM
(pseudomonas)
250, 500, 1g, 2g vial
1, 2g monovial F
Pedcee
500/5 syr
100/1 drops
Cherifer with
Taurine, CGF
syrup / drops
Prozinc
syrup / drops
1, 2g vial
Cefepime
(Cepimax)
150 mkd q8
500, 1g, 2g vial
mkdose:
<2m 30 q8-12 >2m
40 q12
1st-Gram (+) esp Pnemococci, Strep, Staph, Kleb, E coli, Proteus;
Poor activity vs MRSA, Pseudomonas, Enterobacter,
Acinetobacter and B fragilis (PEAB)
nd
2 - 1st gen plus Kleb and B. Fragilis; less active on gram (+)
Poor activity pseudomonas & enterobacter
3rd- Expanded gram (-) coverage; cross BBB; Active vs.
Citrobacter, H. Flu & Neisseria; Poor activity vsEnterobacter
4th More resistant to beta-lactamase; Activity vs PEAB
30
Clusivol
syrup / drops
43
CEPHALOSPORINS
Cefalexin 1
(Ceporex)
25 50
Cefoxitin 1
(Panafox)
Cefaclor 2
(Ceclor,
Xelent)
Cefuroxime 2
(Zinacef,
Zinnat,
Panaxim)
Cefixime 3
(Tergecef,
Ultraxime)
80 160 q6 slow IV
Ceftazidime 3
(Fortum,
Zeptrigen)
Ceftriaxone 3
(Forgram,
Rocephin)
Cefotaxime 3
30 50 q8
20 40 TID
50 100 q8
5 10 mkdose BID
50 100 q24
100 meningitic
q12 24
50 100 q6
MVT / ASCORBIC ACID

250, 500, 1g cap
125, 250/5 susp
125/1.25, 100/1 d
1g vial IV
Ceelin
7 12y
2 6y
2 tsp
1 tsp
1 2y
3 12m
<3m
> 15y
4 15y
1.2 ml
0.6 ml
0.3 ml
2 tsp
1 tsp
1 2y
3 12m
<3m
6 12y
2 6y
1.2 ml
0.6 ml
0.3 ml
2 tsp
1 tsp
6 24m
<6m
YA children
Ychild infants
0.6 ml
0.3 ml
2.5 5 ml
0.5 1 ml
Vitamin A
<2y
>2y
100T u
200T u
Tiki-Tiki Plus
<1 y
Tiki-Tiki Star
Adults
4 12y
1 3y
6 12y
1 6y
2 tsp
1 tsp
tsp
1 tsp
tsp
<1y
0.3 ml
100/5 syr
100/1 drops
250 X, 500 cap

125, 250/5 susp
50/1 drops
250, 500 tab
125, 250/5 susp
250, 750, 1.5 inj
750 monovial
100, 200 cap
50mg/gx6g sach
100/5 susp
20/1 drops
250, 500, 1g IV
250, 500, 1g IM
(pseudomonas)
250, 500, 1g, 2g vial
1, 2g monovial F
Pedcee
500/5 syr
100/1 drops
Cherifer with
Taurine, CGF
syrup / drops
Prozinc
syrup / drops
1, 2g vial
Cefepime
(Cepimax)
150 mkd q8
500, 1g, 2g vial
mkdose:
<2m 30 q8-12 >2m
40 q12
1st-Gram (+) esp Pnemococci, Strep, Staph, Kleb, E coli, Proteus;
Poor activity vs MRSA, Pseudomonas, Enterobacter,
Acinetobacter and B fragilis (PEAB)
nd
2 - 1st gen plus Kleb and B. Fragilis; less active on gram (+)
Poor activity pseudomonas & enterobacter
3rd- Expanded gram (-) coverage; cross BBB; Active vs.
Citrobacter, H. Flu & Neisseria; Poor activity vsEnterobacter
4th More resistant to beta-lactamase; Activity vs PEAB
30
Clusivol
syrup / drops
43
COUGH AND COLDS PREPARATION

Ambroxol
(Mucosolvan, Ambrolex,
Zobrixol)
30,75 cap
30/5 syr
15/5 ped syr
7.5/1 drops
Carbocisteine
(Solmux, Loviscol)
500 cap
100/5 ped syr
50/1 drops
Codeine (Codipront)
30 cap
11/5 syr
Phenylpropanolamine
(Disudrin) q6h
12.5/5 syr
6.25/1 drops
Brompheniramine +
Phenylephrine
(Dimetapp Reformulated)
0.15mkd
Syrup
Drops
TID - QID
>12y
6 12 y
2 6y
1 2y
12 24m
7 12m
<6m
Adult
5 12y
<5y
9 12m
6 8m
35m
<3m
Adult
>14y
6 14y
4 6y
24
7 12y
2 6y
1 2y
7 12m
4 6m
1 3m
7 12y
5 6y
2 4y
1 2 tsp TID
1 tsp
tsp
tsp BID
1 ml BID
0.75ml
0.5ml
1 cap TID
5 10ml
5 ml BID
1 ml QID
0.75 ml
0.5 ml
0.25 ml
1 cap BID
1 tbsp BID
2 tsp
1 tsp
tsp
1 tsp
tsp
1 ml
ml
ml
ml
7.5 ml
5 ml
4 ml
4 6y
2 4y
1 2y
6 12m
3 6m
1 3m
2.5 ml
2 2.5 ml
1.5 2 ml
1.25 1.5
1 1.25
0.75 - 1
42
OTHER ANTIBIOTICS
Amikacin q12
No skin test
Aminoglycoside
Azithromycin
(Zithromax)
Macrolide
Ciprofloxacin
(Ciprobay)
Fluoroquinolone
Chloramphenicol
(Chloromycetin,
Pediachlor)
Clarithromycin
(Klaricid)
Macrolide
Clindamycin
(Dalacin C)
Codeine (Codipront)
30 cap
11/5 syr
Phenylpropanolamine
(Disudrin) q6h
12.5/5 syr
6.25/1 drops
Brompheniramine +
Phenylephrine
(Dimetapp Reformulated)
0.15mkd
42
10 mkd OD x
5d
200/5 susp
250 cap
500 tab/vial
250, 500 tab
100/50,
200/100,
400/200 IV infu
125/5 susp
250, 500 cap
1g vial
250, 500 tab
500 mg OD tab
50 vial
150, 300 cap
75/5 granules
150 amp
80/400 T sus
40/200 B sus
80/400 tab
160/800 forte
500 + 500 vial
20 mkdose q8
50 100 QID
7.5 mkdose
BID
20 30 q6 8
Co-Trimoxazole
(Bactrim, Trizole)
5 8 BID
(Trimethoprim)
Imipenem + Cilastatin
(Tienam)
B-Lactam
Gentamycin
Aminoglycoside
Meropenem
(Meronem)
B-Lactam
10 20
mkdose q8
max: 2g
58
6 7.5 q8
30 mkd
40 meningitic
q8
Vancomycin
(Vancocin)
10 15
mkdose q6
COUGH AND COLDS PREPARATION
TID - QID
100, 250, 500

50, 125, 250/1
20/1; 80/2 amp

500, 1g vial
(HAP, Sepsis,
Neutropenic
pxs)
500 vial
(MRSA)
31
Ambroxol
(Mucosolvan, Ambrolex,
Zobrixol)
30,75 cap
30/5 syr
15/5 ped syr
7.5/1 drops
Carbocisteine
(Solmux, Loviscol)
500 cap
100/5 ped syr
50/1 drops
Syrup
Drops
FT 10
PT 15
>12y
6 12 y
2 6y
1 2y
12 24m
7 12m
<6m
Adult
5 12y
<5y
9 12m
6 8m
35m
<3m
Adult
>14y
6 14y
4 6y
24
7 12y
2 6y
1 2y
7 12m
4 6m
1 3m
7 12y
5 6y
2 4y
1 2 tsp TID
1 tsp
tsp
tsp BID
1 ml BID
0.75ml
0.5ml
1 cap TID
5 10ml
5 ml BID
1 ml QID
0.75 ml
0.5 ml
0.25 ml
1 cap BID
1 tbsp BID
2 tsp
1 tsp
tsp
1 tsp
tsp
1 ml
ml
ml
ml
7.5 ml
5 ml
4 ml
4 6y
2 4y
1 2y
6 12m
3 6m
1 3m
2.5 ml
2 2.5 ml
1.5 2 ml
1.25 1.5
1 1.25
0.75 - 1
OTHER ANTIBIOTICS
Amikacin q12
No skin test
Aminoglycoside
Azithromycin
(Zithromax)
Macrolide
Ciprofloxacin
(Ciprobay)
Fluoroquinolone
Chloramphenicol
(Chloromycetin,
Pediachlor)
Clarithromycin
(Klaricid)
Macrolide
Clindamycin
(Dalacin C)
31
FT 10
PT 15
100, 250, 500

50, 125, 250/1
10 mkd OD x
5d
200/5 susp
250 cap
500 tab/vial
250, 500 tab
100/50,
200/100,
400/200 IV infu
125/5 susp
250, 500 cap
1g vial
250, 500 tab
500 mg OD tab
50 vial
150, 300 cap
75/5 granules
150 amp
80/400 T sus
40/200 B sus
80/400 tab
160/800 forte
500 + 500 vial
20 mkdose q8
50 100 QID
7.5 mkdose
BID
20 30 q6 8
Co-Trimoxazole
(Bactrim, Trizole)
5 8 BID
(Trimethoprim)
Imipenem + Cilastatin
(Tienam)
B-Lactam
Gentamycin
Aminoglycoside
Meropenem
(Meronem)
B-Lactam
10 20
mkdose q8
max: 2g
58
6 7.5 q8
30 mkd
40 meningitic
q8
Vancomycin
(Vancocin)
10 15
mkdose q6
20/1; 80/2 amp

500, 1g vial
(HAP, Sepsis,
Neutropenic
pxs)
500 vial
(MRSA)
ANTIPYRETICS AND ANALGESICS

Anti-inflam
60 90 mkdose
Kawasaki
100 mkd q6
RHD
80 100 mkdq6
10 mkdose
7 12y
10 ml q6
2 6y
5 10
Indomethacin
0.2 mkdose x
25mg/tab + 25 cc
(Indocid)
3 doses
VODKA
Morphine
0.05 0.1 mkdo
10/1 amp
Nalbuphine
0.15 x wt mkdo
10/1 amp
Paracetamol
10 15 mkdose
120/5 syr
(Tempra, Calpol)
250/5 forte syr
100/ml drops
Tramadol
0.5 mkdose
50 mg cap
(Tradonal)
100/2 syr
100/1 drops
Aspirin
(Aspilets) 80
6.5 mkday
Ibuprofen
(Dolan) 100/5
ANTIMICROBIAL SPECTRA OF
SELECTED ANTIMICROBIALS
(from UMED)
LEGEND:
+ = usually effective clinically or >60% susceptible
+ = clinical trials lacking or 30-60% susceptible
0 = not effective clinically or <30% effective
S = synergistic w/ Ampicillin
NT = not tested
32
GIT PREPARATIONS
Dicycloverine
(Relestal)
colic
Domperidone
(Motilium)
Glycerin Suppository
Maalox
Antacids
Omeprazole
(Losec)
5/1 drops
6m 2y
0.5 -1ml q4-6h
0.5 mkd AC
TID - QID
1.9g pediatric supp
2.5g adult supp
2 4 chewtabs
15 ml PC, qHS
2/1 syrup
6 12y
5ml
2 5y 2.5-5ml
1/1 susp
10 tab
Ranitidine
(Zantac)
H2 Blocker
2 4 BID
75,150, 300 tab

150, 300 FR tab
50/2 amp
chew tabs 225/200

susp
10, 20 cap
40 IV
41
ANTIPYRETICS AND ANALGESICS

Anti-inflam
60 90 mkdose
Kawasaki
100 mkd q6
RHD
80 100 mkdq6
10 mkdose
7 12y
10 ml q6
2 6y
5 10
Indomethacin
0.2 mkdose x
25mg/tab + 25 cc
(Indocid)
3 doses
VODKA
Morphine
0.05 0.1 mkdo
10/1 amp
Nalbuphine
0.15 x wt mkdo
10/1 amp
Paracetamol
10 15 mkdose
120/5 syr
(Tempra, Calpol)
250/5 forte syr
100/ml drops
Tramadol
0.5 mkdose
50 mg cap
(Tradonal)
100/2 syr
100/1 drops
Aspirin
(Aspilets) 80
6.5 mkday
Ibuprofen
(Dolan) 100/5
ANTIMICROBIAL SPECTRA OF
SELECTED ANTIMICROBIALS
(from UMED)
LEGEND:
+ = usually effective clinically or >60% susceptible
+ = clinical trials lacking or 30-60% susceptible
0 = not effective clinically or <30% effective
S = synergistic w/ Ampicillin
NT = not tested
32
GIT PREPARATIONS
41
Dicycloverine
(Relestal)
colic
Domperidone
(Motilium)
Glycerin Suppository
Maalox
Antacids
Omeprazole
(Losec)
5/1 drops
6m 2y
0.5 -1ml q4-6h
0.5 mkd AC
TID - QID
1.9g pediatric supp
2.5g adult supp
2 4 chewtabs
15 ml PC, qHS
2/1 syrup
6 12y
5ml
2 5y 2.5-5ml
1/1 susp
10 tab
Ranitidine
(Zantac)
H2 Blocker
2 4 BID
75,150, 300 tab

150, 300 FR tab
50/2 amp
chew tabs 225/200

susp
10, 20 cap
40 IV
ANTIHISTAMINES
Betamethasone +
Dexchlorpheniramine
(Celestamine)
Cetirizine
(Virlix)
6 12y
2 6y
Diphenhydramine
(Benadryl)
1 mkdose
TID
Hydroxyzine
(Iterax)
Loratadine
(Claritin)
0.5 mkdose
BID
0.51 mkdo
BID - TID
0.25 0.5 mkdo

BID
tab/tsp
- tsp
TID
10/1 drops
10 tab OD
1/1 soln
12.5/5 syr
50/1 amp
25, 50 cap
10, 25 tab
2/1 syr
5/5 syr
10tab
STEROIDS
Dexamethasone
0.08-0.3 mkd
q6 q12
LD 7; MD 7
q8
5 25 mg daily
Hydrocortisone
(Solu Cortef)
Prednisone
(Pred 5, Pred 30,
Liquipred)
5/1 inj
100/2, 250/2,
500/4 vial
5, 30 tab
15/5 syr
APPETITE STIMULANTS
Appebon
7 14y
2 6y
adults
child/ adole
PT / infants
6 12y
2 6y
Heraclene
2 6 wks
1mg/cap
Pediafortan AS
2 4 tsp OD
1 2 tsp
3 caps OD
2 3 caps
1 cap
1 2 tsp
1 tsp
40
33
ANTIHISTAMINES
Betamethasone +
Dexchlorpheniramine
(Celestamine)
Cetirizine
(Virlix)
6 12y
2 6y
Diphenhydramine
(Benadryl)
1 mkdose
TID
Hydroxyzine
(Iterax)
Loratadine
(Claritin)
0.5 mkdose
BID
0.51 mkdo
BID - TID
0.25 0.5 mkdo

BID
tab/tsp
- tsp
TID
10/1 drops
10 tab OD
1/1 soln
12.5/5 syr
50/1 amp
25, 50 cap
10, 25 tab
2/1 syr
5/5 syr
10tab
STEROIDS
Dexamethasone
Hydrocortisone
(Solu Cortef)
Prednisone
(Pred 5, Pred 30,
Liquipred)
0.08-0.3 mkd
q6 q12
LD 7; MD 7
q8
5 25 mg daily
5/1 inj
100/2, 250/2,
500/4 vial
5, 30 tab
15/5 syr
APPETITE STIMULANTS
Appebon
Heraclene
2 6 wks
1mg/cap
Pediafortan AS
40
7 14y
2 6y
adults
child/ adole
PT / infants
6 12y
2 6y
2 4 tsp OD
1 2 tsp
3 caps OD
2 3 caps
1 cap
1 2 tsp
1 tsp
33
DPT FOR SEDATION

> 15y
(50mg)
< 15y
Demerol
1ml
0.5ml (25mg)
Phenergan
0.5 ml (12.5mg)
0.25ml (0.25mg)
Thorazine
0.5ml (12.5mg)
0.25ml (0.25mg)
ANTI ASTHMA
Aminophylline
As drip + 15cc D5W
5 mkd LD
0.2 0.5 MD
MD = [(0.2) x wt] x 3 q3h cycles
25mg/ml amp
34
Budesonide
(Budecort)
Respules: 250, 500 ug/ml

500 1000 ug BID initial
250 500 ud BID MD
Doxophylline
(Ansimar)
400 mg tab
100/5 syr
5 9 mkdose
>12 y
<12 y
Adults
10 ml BID
6 9 ml BID
1 tab TID
Salbutamol
(Ventolin)
2 mg tab, 2/5 syr
2.5/2.5 nebules
100 ug inhaler
Terbutaline
(Bricanyl)
2.5 mg tab
0.3 mg/ml syr
>12
7 12y
2 6y
1 2 tab / tsp
1 tab / tsp
tab / tsp
7 15y
3 7y
<3y
5 10 ml BID
2.5 ml BID
0.075 mkd
39
DPT FOR SEDATION

> 15y
(50mg)
< 15y
Demerol
1ml
0.5ml (25mg)
Phenergan
0.5 ml (12.5mg)
0.25ml (0.25mg)
Thorazine
0.5ml (12.5mg)
0.25ml (0.25mg)
ANTI ASTHMA
Aminophylline
As drip + 15cc D5W
5 mkd LD
0.2 0.5 MD
MD = [(0.2) x wt] x 3 q3h cycles
25mg/ml amp
34
39
Budesonide
(Budecort)
Respules: 250, 500 ug/ml

500 1000 ug BID initial
250 500 ud BID MD
Doxophylline
(Ansimar)
400 mg tab
100/5 syr
5 9 mkdose
>12 y
<12 y
Adults
10 ml BID
6 9 ml BID
1 tab TID
Salbutamol
(Ventolin)
2 mg tab, 2/5 syr
2.5/2.5 nebules
100 ug inhaler
Terbutaline
(Bricanyl)
2.5 mg tab
0.3 mg/ml syr
>12
7 12y
2 6y
1 2 tab / tsp
1 tab / tsp
tab / tsp
7 15y
3 7y
<3y
5 10 ml BID
2.5 ml BID
0.075 mkd
ANTICONVULSANTS
Carbamazepine
(Tegretol)
Gen Tonic Clonic
Clonazepam
(Rivotril)
10 mkd; to
20/1 syr
20-30mkd TID
200 tab/SR tab
(8-12 meq/mL)
<30 kg 0.05 mkd BID-TID
max: 0.2mkd
>30 kg 1.5 mkd TID nmt 20mg/d
Absence, Myo, Partial

Infantile Spasm
Diazepam
(Valium)
2mg/ tab
Ethosuximide
(Zarontin)
Absence
Phenobarbital
GTC
Phenytoin
(Dilantin)
Valproate
(Epival, Depakene
GTC, Absence
0.2 mkdo IV
0.3 mkdo IM
0.4 mkdo rect
20 mkd; to 40
mkd
(40-100 meq/ml)
3 5 mkd BID
LD:15 mg/kg
(15-40 meq/ml)
3 9 mkd BID
LD: 20mg/kg
Max infu rate:
1mg/kg/min =
cardiac standstill
10 mkd
30 60 mkd TID
QID
(50100 meq/ml)
SEDATION FOR EEG
10/2 amp
2, 5, 10 tab
15, 30, 60, 90 t

30, 125/5 susp
30, 100 tab
100/2 inj
250 tab E
250/5 syr D
Benadryl 1 mkdose
Phenergan + Thorazine
Benadryl + Thorazine
NO DORMICUM,
epileptiform focus
DIAZEPAM,
LUMINAL
will
remove
38
35
ANTICONVULSANTS
Carbamazepine
(Tegretol)
Gen Tonic Clonic
Clonazepam
(Rivotril)
10 mkd; to
20/1 syr
20-30mkd TID
200 tab/SR tab
(8-12 meq/mL)
<30 kg 0.05 mkd BID-TID
max: 0.2mkd
>30 kg 1.5 mkd TID nmt 20mg/d
Absence, Myo, Partial

Infantile Spasm
Diazepam
(Valium)
2mg/ tab
Ethosuximide
(Zarontin)
Absence
Phenobarbital
GTC
Phenytoin
(Dilantin)
Valproate
(Epival, Depakene
GTC, Absence
0.2 mkdo IV
0.3 mkdo IM
0.4 mkdo rect
20 mkd; to 40
mkd
(40-100 meq/ml)
3 5 mkd BID
LD:15 mg/kg
(15-40 meq/ml)
3 9 mkd BID
LD: 20mg/kg
Max infu rate:
1mg/kg/min =
cardiac standstill
10 mkd
30 60 mkd TID
QID
(50100 meq/ml)
SEDATION FOR EEG
10/2 amp
2, 5, 10 tab
15, 30, 60, 90 t

30, 125/5 susp
30, 100 tab
100/2 inj
250 tab E
250/5 syr D
Benadryl 1 mkdose
Phenergan + Thorazine
Benadryl + Thorazine
NO DORMICUM,
epileptiform focus
38
DIAZEPAM,
LUMINAL
will
remove
35
ANTI KOCHS
Isoniazid
(Comprilex) with
pyridoxine 12mg
Rifampicin
(Rifamax, Rimaped)
Pyrazinamide
Combikids
{Novartis}
Kidz Kit 2
{Natrapharm}
Ethambutol
> 8 y/o
Streptomycin
(Karnataka)
ANTIFUNGALS
5 10 OD
200/5 syrup
100, 300 tab
Fluconazole
(Diflucan)
10 15
200/5 susp
100/1 d Rifamx
450 cap
250/5 susp
500 tab
Nystatin
(Mycostatin)
15 30
max: 2g/d
Rif
200/5
INH 100/5 + pyridoxine 5/5
PZA 250/5
Rif
200/5
INH 200/5
15 25; OD
400 tab
50 mkdo if 2x/wk
max: 2.5g/24h
10 IM x 7 10d
1g vial
max: 40 mkd
LD 12
MD 6
mkdose
Chd/Ad 4-6
ml Infants
2 ml
50, 150, 200 cap

2/1 vial
100T u/ml susp
500T u tab
ANTIVIRALS
Inosiplex
(Immunosin)
6 12y
5 ml
2 6y
3 ml
1 2y
2 ml
6 12m 1.5 ml
<6m
1ml
Acyclovir
(Zovirax)
250/5 syr
q4 h q6 x 7d
>6y 800mg QID

<2y 200mg QID or 20 mkd QID
adults: 800mg 5x a day
200, 400, 800 tab
250 vial
5 days treatment
ANTHELMINTICS
Mebendazole
(Antiox)
AMOEBECIDES
Metronidazole
(Flagyl, Abbott)
50 100 mkd
30 50 TID
(amoebiasis)
Diloxanide Furoate
(Furamide)
20 40 q8 x 10d
Etofamide
(Kitnos)
15 20 TID x 3d
125/5 susp
5/1 premxd v A
500 forte tab
500/100 IV infu
125/5 susp
500 tab
Pyrantel Pamoate
(Combantrin)
100/5 susp
200, 500 tab
36
37
ANTI KOCHS
Isoniazid
(Comprilex) with
pyridoxine 12mg
Rifampicin
(Rifamax, Rimaped)
Pyrazinamide
Combikids
{Novartis}
Kidz Kit 2
{Natrapharm}
Ethambutol
> 8 y/o
Streptomycin
(Karnataka)
100, 500 tab

500mg single dose
20/1 susp
5 ml BID x 3d
50/1 susp
10 ml single dose
>15y
500 mg
q3mos
10 14 375 mg
59
250 mg
125, 250 tab
<5
125 mg
125/5 susp
ANTIFUNGALS
5 10 OD
200/5 syrup
100, 300 tab
Fluconazole
(Diflucan)
10 15
200/5 susp
100/1 d Rifamx
450 cap
250/5 susp
500 tab
Nystatin
(Mycostatin)
15 30
max: 2g/d
Rif
200/5
INH 100/5 + pyridoxine 5/5
PZA 250/5
Rif
200/5
INH 200/5
15 25; OD
400 tab
50 mkdo if 2x/wk
max: 2.5g/24h
10 IM x 7 10d
1g vial
max: 40 mkd
LD 12
MD 6
mkdose
Chd/Ad 4-6
ml Infants
2 ml
50, 150, 200 cap

2/1 vial
100T u/ml susp
500T u tab
ANTIVIRALS
Inosiplex
(Immunosin)
Acyclovir
(Zovirax)
5 days treatment
6 12y
5 ml
2 6y
3 ml
1 2y
2 ml
6 12m 1.5 ml
<6m
1ml
250/5 syr
q4 h q6 x 7d
>6y 800mg QID

<2y 200mg QID or 20 mkd QID
adults: 800mg 5x a day
200, 400, 800 tab
250 vial
ANTHELMINTICS
Mebendazole
(Antiox)
AMOEBECIDES
Metronidazole
(Flagyl, Abbott)
50 100 mkd
30 50 TID
(amoebiasis)
Diloxanide Furoate
(Furamide)
20 40 q8 x 10d
Etofamide
(Kitnos)
15 20 TID x 3d
36
125/5 susp
5/1 premxd v A
500 forte tab
500/100 IV infu
125/5 susp
500 tab
Pyrantel Pamoate
(Combantrin)
100/5 susp
200, 500 tab
37
100, 500 tab

500mg single dose
20/1 susp
5 ml BID x 3d
50/1 susp
10 ml single dose
>15y
500 mg
q3mos
10 14 375 mg
59
250 mg
125, 250 tab
<5
125 mg
125/5 susp

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NOTES

FLUIDS (Ludans Method)

Fluid Challenge: 20cc/kg/h of D5LRS; can be done 3x; max of

D50.3 NaCl in 6 hours

Total Fluids = BSA (400) + urine output

(wt) (0.05) + 0.05

(wt) (0.04) + 0.1

(wt) (0.03) + 0.2

(wt) (0.02) + 0.4

If no UO; (1cc/k/h) + BSA (400)

FLUIDS (Ludans Method)

Fluid Challenge: 20cc/kg/h of D5LRS; can be done 3x; max of

D50.3 NaCl in 6 hours

Total Fluids = BSA (400) + urine output

(wt) (0.05) + 0.05

(wt) (0.04) + 0.1

(wt) (0.03) + 0.2

(wt) (0.02) + 0.4

If no UO; (1cc/k/h) + BSA (400)

FLUIDS (Holliday-Segar Method)

Caloric Expenditure in 24h

1000 kcal + 50 kcal/kg for each kg>10

1500 kcal + 20 kcal/kg for each kg>20

FLUIDS (BSA Method)

Caloric Expenditure in 24h

1000 kcal + 50 kcal/kg for each kg>10

1500 kcal + 20 kcal/kg for each kg>20

FLUIDS (Holliday-Segar Method)

Caloric Expenditure in 24h

1000 kcal + 50 kcal/kg for each kg>10

1500 kcal + 20 kcal/kg for each kg>20

FLUIDS (BSA Method)

Caloric Expenditure in 24h

1000 kcal + 50 kcal/kg for each kg>10

1500 kcal + 20 kcal/kg for each kg>20

BURN: GALVESTON FORMULA

RISK CLASSIFICATION OF PNEUMONIA-RELATED MORTALITY

DAILY FLUID REQUIREMENT

5 L/m2 burned BSA +

24h maintenance fluid

BURN: GALVESTON FORMULA

RISK CLASSIFICATION OF PNEUMONIA-RELATED MORTALITY

DAILY FLUID REQUIREMENT

5 L/m2 burned BSA +

BURN: PARKLAND FORMULA

3 ml/kg/% burned BSA (<30%)

GIR (4-8 CC/K/H)

(0.167 x dext) IV rate

Vol cc x 8 x ___ cal

Sneezers and Runners

Watery, anterior and

Thick mucous, more

Worse during day,

Constant, day and night,

BURN: PARKLAND FORMULA

3 ml/kg/% burned BSA (<30%)

GIR (4-8 CC/K/H)

Vol cc x 8 x ___ cal

History of nasal discharge, blockage, sneeze/itch

History of nasal discharge, blockage, sneeze/itch

Sneezers and Runners

Watery, anterior and

Thick mucous, more

Worse during day,