EMERGENCY DRUGS

Epinephrine 0.01-0.03 mkd q3-5min

Atropine
0.02-0.03 mkd(max0.5mg)
Adenocard 6 mg initially; 12mg nxt
Adenosine
6mg/2mL
Ca Gluc 10% 0.1-0.2 mkd
Captopril
0.3-0.5 mkd q6-12h
Capoten
25mg/tab
Hydralazine
0.1-0.2 mkd
Apresoline
PO: 10mg; 25
IV: 20mg/amp
L-Carnitine
50 mkd q4-6h(N)
30-40mkd??
Carnicor
PO: 1/10; 330
IV: 1/5
Lidocaine
1.0 mkd bolus
20-50 ugKmin
Mannitol 20% 1-2 mkd
Prep 1.2% soln (1 med/mL)
NaHCO3
1.5-2.0 mkd
Naloxone
0.1 mkd
Plain
0.4mg/1mL
Neonatal
0.02mg/1mL
Nifedipine
0.25-0.5 mkdq4-6h
Nipride
0.5-1.5 ugkm**
Urecholine
2.9mg/m2/d q8 PO**

CEPHALOSPORINS
1st Generation
Cephalexin 25-100 mkD q6-8h/ 250-500
Cefadroxil 30 mkD BID(max:2g)
Cefalothin 50-100 mkD QID
Cefazolin
50-100 mkD q8
Cephradine 50-100 mkD q6-12
2nd Generation
Cefamandole 50-100 QID
Cefaclor
20-40 mkD q8-12
Ceclor
125/5; 250/5 DS
Cefuroxime IV: 200-240 mkD q8
PO: 20-30 mkD BID
3rd Generation
Cefotaxime 150 mkD q6-8 (menin:200)
NB:<7 100mkd q 12H;
1g q8-12 for > 12yo & 2g-adults
Claforan
500mg; 1g; 2g
Ceftriaxone NB
50-75mkDOD
Child: 50-75 mkD OD
Meningitis LD:75mkd,80-100mkDq12-24
Adult: 1-2 g OD

AMINOGLYCOSIDES
Amikacin
Kanamycin
Tobramycin
Gentamycin

10-15 mkD/15-25mkDq8-12
Prep: 100/2; 250/2
30-50 mkD
6-8 mkD (Nebcin)
5-8 mkD IV

MACROLIDES
Erythromycin
Erythrocin

30-50 mkD
200/5; 400/5 ds; 100/2.5gtts

Azithromycin 10 mkD ODx1D,5mkDx4D

Grp. A Strep
12mkDx5 D
Clarithromycin
Klaricid

15 mkD q12 or
7.5 mkd
125/5 (dont ref)

ANTI-STAPH
Nafcillin
100-200 mkD q6
Vigopen
250/5
Co-Amoxiclav 40-60 mkD
Augmentin 156/5; 312/5
Stafloxin
100-200 mkD
Vancomycin 40-60 mkD
Cloxacillin
50-100 mkD q6
Prostaphlin-A
125/5
Orbenin
250; 500
Oxacillin
100-200 mkD IV
(Prostaphlin)
OTHER B-LACTAMS
Imepenem 60-100 mkD q 6 or 8
NB: 20 mk q 12
Piperacillin (Cypercil)
Less Serious: 100-200 MKD q6
Serious:
200-300 MKD
Vancomycin 40-60 MKD (give in 2h) q 8 or 12
Meropenem 20 mkd q 8 or 60 mkD q 8 hrs
40 mkd q 8 hrs newborn septic

Ceftazidime 150 mkD q 8 hrs

(Fortum)
< 2mo: 25-50 mkD BID
> 2mo: 30-100 mkD TID
Adult: 1-6 g/day TID
Cefoperazone 100-150 mkD
Child: 50-200 mkD BID
Adult: 2-4 gkD q12
Cefobis
Cefoxitin
50-100 mkD q6-12
Mefoxin
1 g/vial
Ceftizoxime Child: 40-80 mkD bid-qid
Adult: 0.5-2 g/d
2-4 doses IV/IM
Cefixime
3-6 mkD BID
Tergicef
100/5 (50mg/ml)
Cefdinir
9-18 mkD q8
Omnicef
50mg/sachet;
100mg/cap
Cedax
9 mkD OD
(180/5)
Cefetamet 20 mkD OD q12
Globocef
250/5
4th Generation
Cefepime
for severe infection, 50 mkd q8
2mo old, BW <40kg = 50 mkq12x10d
Newborns 30 mkd q 8 hrs

ANTI-TB
INH
Tx: 5 mkD liver
Px: 10-15 mkD peri. neuritis
Trisovit
50/5
Nicetal
100/5
Primafort
100/5
Odinah
150/5
Trisofort
200/5
Pyrobin H
150/5
Comprilex
200/5
Ethambutol 20mkD optic neuritis
Myambutol
200/5
Ethambin
125/5
Isoetham
150/5
Ethambin/INH 150/5; 125
Rifampicin
10 mkD (liver)
Rimactane
100/5; 200/5
150; 300; 450; 600
Meningo Px:
Adult:
600 q12 x 4 doses
1-12yo:
10 mk q12 x 4 doses
3mo-1y:
5 mk q12 x 4 doses
Streptomycin 20-30 mkD OD IM ototoxic
PZA
15 mkD
Give PO pre breakfast

ANALGESICS

PENICILLINS

Fentanyl

PCN:

Low: 2 mkD
Mod: 2-20 mkD
High: 2-50 mkD
Sublimaze (Janssen): 50ug/2mL
Ibuprofen 5-10 mkd q6-8
Dolan FP
100/5
Mefenamic acid 3-5 mkD
Ponstan
50/5
Midazolam
0.1 mkD
Dormicum
IV: 5/1;5/5;15/3
PO: 5mg/tab
Morphine
0.1-0.2 mkD
Morphine
10/mL
Nalbuphine
0.1 mkD
Nubain
10/mL
Pancuronium
0.04-0.1 mkD
Promethazine
Phenergan
IV: 50/2
PO: 1/1; 10mg
Ketorolac 0.25 mkd q 6 hrs

50-100TUKD or
25-30 mkD
625mg = 1 MU
250/5 = 400 TU
312.5/5= 500 TU
500mg = 800 TU
Oral PCN
100-200 TUKD
Pentacillin
50/5; 500mg
Sumapen
25/5; 250; 500
Megapen
50 TU/mL gtts
312.5/5; 625mg
Amoxicillin 20-50 mkD q8
80-90mkD-OM
Nafcillin
100-200 mkDq6
Stafloxin
100-200 mkD
Ampicillin
100-200 mkD
(NB: 50-100 BID;
men: 300-400 mkd q6)
Unasyn 25 mkD q 6 hrs
Ampicin/Pentrexyl/Aldribid
Bacampicillin 25-50 mkD
Penglobe
200/5

ANTI-HELMINTHIC
Oxantel pamoate 10-20 mkd
Quantrel
100/5; 100
Tetramizole
2.5-5 mkd SD
TMZ
25mg/10mL
Mebendazole 100 mkd BID x 3 days
Antiox: 100; 500mg/tab; 20mg susp
Combantrin 125mg; 250mg/tab
125mg/5mL susp
>15yo = 500 mg
10-14yo = 375 mg
5-9 yo = 250 mg
5 yo = 125 mg
ANTI-VIRAL
Methisoprinol 50-100 mkD
Isoprinosine
250/1; 500
Inosiplex
50 mkD
Immunosine
250/5
Amantadine 5-8 mkD
Symmetrel
50/5
Virazole
10 mkD
Acyclovir
10-15 mkD q6 x 5D
Zovirax
250/5; 200

ANTI-ASTHMA
Aminophylline LD: 8-10 mk
MD: 3-5
Drip:
0.4-0.9 mkH
Neonate: 1 mkd q8 or 2 mkd q12
Apnea: LD: 5-6 mkd (o.5-0.9 m/k/hr
infusion)
MD: 2 mk 12h post-LD
Prep: 250/10
Drip: eg: 5kg at 0.4 mkH in 8h drip:
5 x 0.4 x 8 = 16mg in 8h
if IVF rate is 5cc/h, fill soluset
with 40cc IVF+ 16mg
Amino (0.64mL)
Theophylline 3-5 mkd
Nuellin
80/15; 50; 125; 250
Terbutaline SQ: 0.005 mkd
PO: 0.075 mkd
Drip: 0.003 mkH
Bricanyl
IV: 0.5/1
PO: 1.5/5; 2.5
Salbutamol 0.12-0.15 mkd
Ventolin
2/5 sy; 1.2/5 exp; 2
Librentin
2/5; 2mg
Prox-S
2/5; 2mg
Atrovent
4-8gtts/mL NSS

ANTI-DERMATOSES

COUGH

Hydrocortisone 1% TID x 2 wks

Hytone/Hydrotpic/Eczacort
Betamethasone
BID-TID
Betnovate/Diprolene/Diprosone
Fluocinolone acetonide BID-TID
Aplosyn 10; 25; HP
Synalar 10; 25; HP
Mometasone furoate OD
Elica/Momate
Clobetasole propionate
Dermovate
Diflucortolone valerate BID-TID
Nensona
Desoximetasone
BID-TID
Esperson
Triamcinolone acetonide BID-TID
Kenacort A/Ladercort A

Ambroxol
1.2-1.6 mkD q12
Mucosulvan
15/5; 7.5/1.5
Zobrixol
15/5; 7.5/1.25
Salvotran
15/5; 30/5
Bromhexine
7-12y = 1 tsp TID
2-6y = tsp TID
Bromulex
4mg/5mL; 8mg
SCMC
20-30 mkD
Loviscol
50/1; 100/5
Solmux
40/1; 200/5
Cemetol
200/5
Erdosteine

10 m/dk/d BID
175mg/mL

DIAZEPAM DRIP
0.3 mkH dilute in NSS makes 0.1mg/mL
conc = mg/total vol (mL

ANTI-HISTAMINES
Diphenhydramine 3-5 mkD TID-QID
Benadryl
IV: 50/1x3 dose
PO: 12.5; 25; 50
Methdilazine
0.3 mkD q12-q6
Tacaryl
4/5; 4; 8
Clemastine
0.05 mkD q12
Tavegyl
0.5/5; 1mg
Hydroxyzine
1 mkD
Iterax
2mg/ml; 10; 25
Cetirizine
0.25 mkD
Virlix
10mg/1mL
Loratadine
2-12yo, < 30k: 1 tsp OD
>30k: 2 tsp OD
Claritin
5mg/5mL
Ketotifen 0.025 mkd q12
Zadec
1mg/5mL; 1mg
Zaditen
0.2mg/1mL; 1
ATROPINE SULFATE
Pedia 1-2 mg SQ q 20min
0.2 Mkd q 3-5min
Adult 2mg q 10 min IV/IM
0.5mg (5mL) q 3-5min
Mkd PRN after 24h

DIURETICS
Furosemide
1.0-2.0 mkd
Lasix
20/2; 40mg
Frusema
20/2; 20mg; 40
Diazoxide
5-10 mkd
Diazoxide
300/2
Acetazolamide 20-30 mkD
Diamox
250mg/tab
Spironolactone 1.5-3.0 mkD
Aldactone
25mg/tab
Hydrochlorothiazide 1-2 mkD
Dichlotride
25mg; 50mg/tab
Mannitol 20%
1.5-2 gkD or 5cckd
200g/1L; (1gm = 5 cc; 0.5-1gkd)
DOPAMINE DRIP
1-5 ug/k/min = VD, inc renal & splan circ
5-10ug/k/min = inotropic; no effect on HR
10-20 ug/k/min = inc BP

Prep: Dopamine: 200/5

Conc
Dopa
S
800
1 cc
DS 1600
2 cc
QS 3200
4 cc

D5W
49 cc
48 cc
46 cc

Prep: Dobutamine: 250/2

Conc
Dobu
S
1000
4cc
DS 2000
8 cc
QS 4000
16 cc

D5W
46 cc
42 cc
34 cc

Computation for concentration:

1. D5W 250 + 200 mg/amp
200/250 = 0.8 mg/cc = 800 ug/cc
1 cc = 60 ugtts
conc = 600/60 = 13.33 ug/ugtts
2. Lidocaine 2%
2 g/100 mL = 20 mg/mL
AD = rate x conc
Wt x 60

Rate = RD x Wt x 60
Conc

STEROIDS

ELECTROLYTES

PARACETAMOL

Dexamethasone
Decadron
Hydrocortisone

Vitamin K 0.3 Mkd (max 5 mg) x 3 dys

Aeknil
Afebrin
Biogesic
Calpol
Crocin
Defebrol
Naprex
Opigesic
Rexidol
Tempra
Tylenol
Winadol

0.2-0.4 mkd
4/1
LD: 10 mk
MD: 5 mkD
Solu-cortef
100/2; 250/2
Act-o-vial
100
Prednisolone
0.7 mkD
Solumedrol
125/2
Prednisone
0.5 mkD
1 mkD (BA)
Methylprednisolone 1.5 mkD q 6 hrs
ALBUMIN
Albumin: 1 g/K/dose
Alburein 12.5g/50mL (25%)
Formula: Desired-Actual x 1.2 x Wt
Albumin 0.5-1.0 g/K (max 6 gKD)
Albumer/Albutein 50/1 (5%)
250/1 (25%)

Calcium gluconate 10% 1 cc/k/shift

IV MD: 200-500MKD q6 or drip
(Max 200 Mkd in 10 min)
IV: 100/1 (9 el. Ca/ml or 0.45mg
Ca/ml)
PO: 500 mg (45 mg Ca)
650 mg (58.5 mg Ca)
Iron

Tx: 4-6 MKD

Px: 1-2 MKD
Iberet
500 mg (26.25 elem Fe)
Odiron
50mg/10mL; 25mg/5mL
Fer-in-sol 15mg/0.6ml; 18mg/5mL
Propan
25mg/5mL
Ferlin
30mg/5mL; 15mg/1mL
Incremin
30mg/5mL
Polyvifer 10mg/1mL

Glucagon

0.25-0.3 mkd
0.3 mkd-1mg in IDM
1 mg (1 U) vial

10-15 mkd

300mg/2mL
120mg/5mL; 325mg; 500
100mg/1ml; 250/5; 500
120mg/5mL; 250mg/5mL
125mg/5mL; 500mg
60mg/0.6mL; 120mg/5mL
250mg/5m; 500mg
125mg; 250mg
150mg/5mL; 60/0.06; 600
120mg/5mL; 60mg/0.06mL
120mg/5mL
120mg/5mL; 500mg

SALICYLATES
Anti-rheumatic
Asaped
Ascriptin
Aspirin Gr V
Neo-Novaldin
Superin

65-130 mkD
81mg
325mg
Gr 1 = 65 mg
325mg
180mg/5mL; 3g

LUMBAR TAP
Pressure (in cmH2O)
G 22 (1 ) = gtts in 21 sec
G 22 (3 ) = gtta in 39 sec
G 20 (3 ) = gtts in 12 sec

HS METHOD for IVF Infusion

BALLARDS MATURITY TESTING

2.5-10kg 100cc/k/day
10-20kg 1000cc+50cc/k over 10k
>20kg
1500cc+20cc/k over 20k

Score

AOG (wks)

WBC correction in traumatic tap:

Periph WBC x 1000 =
WBC
5,000,000
1000 RBC

TF/4 = cc/hr or ugtt/min

5
10
15
20
25
30
35
40
45
50

26
28
30
32
34
36
38
40
42
44

C/I: increased ICP

severe CP depression
infected skin
decreased platelet count or blood d/o
brain abscess
colorless, 50-80 mmH2o, WBC 5/mm3 CHON
<45 Glucose 60-75% of blood glucose
PHOTOTHERAPY
Indication: PT: 10 mg% bilirubin
FT: 15 mg% bilirubin
Complications:
osmotic diarrhea
rashes
bronze baby syndrome
dehydration

Phototx
+20%
Tachypnea
+25-50%
Fever
+12% q 1oC > 37.5oC
Hypermetabolic +25-50%
Burns
+14% for 1st Degree
Sweating
+10-25%

CHARACTERISTICS OF
PROXIMAL & DISTAL SBO
KVO: ugtt = 3.5
gtt = 10

HIGH SBO
Acute onset
Prominent vomiting
Vomit not feculent
Pain frequent
minimal distension

LOW SBO
less acute
less prominent
often feculent
less frequent
prominent

SA = Wt x 4 + 7 x 400 (renal)
Wt + 90

RANSONS CRITERIA for

ACUTE PANCREATITIS

Men
Preterm
CHF
Cardiac
Renal
MF

SA x 1500
SA x 1200
SA x 800
SA x 200
SA x 400 + 24h UO
< 2yo = SA x 1500
> 2yo = SA x 1200

On Admission:

0-5 kg
6-10 kg
10-15k
15-20k

wt x 0.05 + 0.05
wt x 0.04 + 0.1
wt x 0.03 + 0.2
wt x 0.02 + 0.3

CRITERIA FOR RHEUMATIC FEVER

Major: carditis, polyarthritis, chorea,
subcutaneous nodules, erythema marginatum
Minor: hx of RF/RHD, arthralgia, fever,
elevated ASO, CRP & ESR, prolonged
PR interval, (+) culture of Grp. A strep

1. age > 55 yrs

2. leukocytosis > 16,000
3. hyperglycemia > 200mg/dL
(11mmol/L)
4. serum LDH > 400 IU/L
5. serum AST > 250 IU/L
During the initial 48hrs:
1. hematocrit fall > 10%
2. fluid sequestration > 4000 mL
3. hypocalcemia < 8mg/dL (1.9mmol/L)
4. hypoxemia (PO2 <60mmHg)
5. BUN rise >1.85mg/dL (>1.8mmol/L)
post IVF
6. hypoalbuminemia < 3.2g/dL (32g/L)

CRITERIA FOR AMI

1.typical pain: retrosternal, severe, pain
lasting >30min, unrelieved by nitrates,
cold, clammy perspiration
2. evolutionary ST elevation followed by
Q wave formation and ST segment
inversion
3. elevation of serum CPK-MB
Labs:
Onset
CPK-MB 4-6h
SGOT
8-12h
LDH
12-24h

Peak
12-24h
36-48h
2-4days

Duration
24-48h
3-5days
7-10days

ABG
H=

24 x pCO2
HCO3

Chronicity: H 40 ; if < 0.3 = chronic

pCO2
0.3-0.7 = ac/chr
> 0.8 = acute
Oxygenation:
80-100
adequate
60-80 mild hypoxemia
40-60 moderate
< 40 severe

CPAP
TFR = wt x TV(10-15) x RR x IE ratio(2)
+ 2000 (2L)
FiO2 = CA (0.2) + 02 (1) x 100
TFR
CA = 100 FiO2 x TFR
79
O2 = FR CA
ET Size: > 2 yo = age(yrs) + 16
4
HR
RR
2-12 mo = <160
< 2 mo = up to 60
1-2 yo = <120
2mo-2yr = 50
2-8 yo = <110
1-5 yo = 40
IE: 60/RR - IT
IT
PEFR
Ht= x 100 x 5 + 170 (F)/175 (M)
% PEFR = actual x 100
expected

pH
7.35-7.45 = 7.4
pCO2
35-45
= 40
HCO3
22-26
= 24
O2
80-100
Neonates: 7.3-7.4; 35-45; 24-26
Metabolic Acidosis:
pCO2 = 1.5 (HCO3) + 8.4 2 limit 10
Metabolic Alkalosis:
q 1meq/L inc HCO3 there is 0.5-1.0 increase in
pCO2 limit 55
Respiratory Acidosis:
Acute: 3-4 meq/L inc HCO3 q 10mmHg inc
pCO2
Chron: 0.4 meq inc HCO3 q 10mmHg
inc pCO2
Respiratory Alkalosis:
Ac: 2-4meq dec HCO3 q 10mmHg dec
pCO2 limit 18
Chr: 0.5meq dec HCO3 q 10mmHg dec
pCO2
def: 0.3 x ABE x wt (half correction)

JAUNDICE
VITAL SIGNS
Clinical Jaundice
manifestation of color starting
at serum bilirubin levels 5-7 mg%
Criteria to rule out physiologic jaundice:
1. Clinical jaundice in the 1st 24 hrs of
life.
2. Increase in total serum bilirubin at
> 5 mg/dL/day (85 umol/L).
3. Total serum bilirubin > 12 mg/dL in
full term, and > 15 mg/dL in
preterm.
4. Direct bilirubin > 1.5-2 mg/dL
(26-34 umol/L).
5. Jaundice lasting for more than 1
week for term, 2 weeks for
preterm.

I. HEART RATE
<2 mo
140-160
2-12 mo 120-140
1-2 yo
100-120
2-8 yo
90-110
II. RR
<2 mo
up to 60
2mo-1yr
50
1y-5y
40
III. BP
syst
upper :yrs x 2 + 90
lower: yrs x 2 + 70
diast
30 mm Hg lower

INTUBATION/EXTUBATION
INTUBATION
ET SIZE
> 2yo: age (yrs) + 16
-------------------------------------

4
PT: 2 or 2.5
FT: 3 or 3.5
ET LENGTH
age/2 + 12
kg
cm
1
7
2
8
3
9
EXTUBATION CRITERIA
FiO2 < 50
P/F
no electrolyte imbalance
control of infection
good muscle mass
racemic epi (0.3 mL + 4.7 PNSS)
2.5 mL x 3 d (q4-6)
Dexamethasone 6 hrs prior
then 24 hrs

CARI

MALCOLM HOLIDAY
(1/4 1st hr; 7 hrs)

2mo-2 yo:
Mild Pneumonia:
send home, TMP-SMX,
Tx fever, ff-up in 2-4 days

< 2 yo
> 2 yo

Severe Pneumonia:
Admit, give IV/IM Benzyl PCN,
Tx fever, tx wheezing,
supportive care, reassess daily

Hydrite 1 tab in 100cc water = 8h

Glucost 1 sachet in 100cc water = 8h
Oresol
1 sachet in 1L water = 24h
Glucolyte 1 sachet in 200cc water

Very Severe Pneumonia:

Admit, give O2, Chloramphenicol,
tx fever and wheezing,
reassess BID (q 15min if possible)

FLUIDS AND ELECTROLYTES

< 2 mos:
Severe Pneumonia:
Hospitalize, keep warm,
give 1st dose antibiotic Benzyl PCN/
Garamycin/Gentamycin

Mild
50
30

Moderate Severe
100
150
60
90

1. Hypotonic: D5W; D5NM; D5 0.3NaCl;

D5 IMB; Isolyte; D5 Maintresol
2. Isotonic: D5LR; D5 NSS; PLR; PNSS
3. Hypertonic: D50W; D10W

STAGES OF DHF
1. Febrile
2. Afebrile
3. Convalescent
GRADING OF DHF
1. Fever + non-specific ssx; (+)
tourniquet test
2. Gr. 1 + spontaneous bleeding
3. Gr.2 + manifestations of circulatory
failure: rapid, weak pulse; narrow
pulse pressure; HPOT; cold, clammy
extremities
4. Profound Shock with undetectable BP
& pulse
Days 1-5: petecchiae, fever
Days 5-7: bleeding
> Day 6 : shock
CLASSICAL DENGUE FEVER
1. Thrombocytopenia not < 100T
2. Hemoconcentration not > 20% of
baseline

IV FLUIDS
Na
IMB
25
NM
40
NSS
154
LR
130
NMR
40
IsolyteM 40
IsolyteP 25
PLP48 25
0.3%
51
0.6% 102
0.45
77
0.9% 154
ORS
90
P-lyte90 90
P-lyte Pl 45

IVF OF CHOICE
K
20
13

Cl
22
40
154
4 109
30
35 40
20 20
20 22
51

HCO3 Ca PO4
23
3 3
16
3 3
28

102
77
20
20
20

154
80 30 (20 gluc)
80
35

Na = 1 meq = 23 mg
K = 1 meq = 39.1 mg

LBM
Vomiting
Maintenance
BA
Fever & Sweating
Drowning
Ascitis
CHF
HPN
CHF (NPO)
2o to HPN
Heat Stroke
Burns
Azotemia
Inc BUN
Bleeding
UTI
Profuse Bleeding
Dengue Fever
DM

ELECTROLYTES
PLR
D5 NSS
D5 NM
D5 0.3% NaCl
D5 0.3% NaCl;
D5W
D5W; D10W
D5 NSS
D5W/D5LR(BP)
D5 NSS
D5W
D5 NSS
PLR
D5W
D10W
D5 LR
D5 NSS
D5 LR
D5 0.3% NaCl
PNSS

Na = 135-145 meq
K = 4-5.6 meq
Ca = 8-10 meq
Cl = 98-106 meq

(RV= 136 meq)

(RV= 4 meq)

Deficit = (desired-actual) x Wt x 0.6

Adult = desired-actual x 350
3
Maintenance:
Na = 3 meq/kg
K = 2 meq/kg
Na/K deficit is given in 3 days
Na/K delivery = 0.1-0.4 meq/kg
Full incorporation = 40 meq/L

IBW
2-12 mo = age in mo x 10
= wt in lbs
< 6 mo = age in mo x 600 + BW
= wt in gms
6-12 mo = age in mo x 500 + BW
= wt in gms
< 1 yo
= Age (mo) + 9
2
> 2 yo
= age in yrs x 2 + 8
= wt in kg
= age in yrs x 5 + 17
= wt in lbs
4.5
1 yo
2 yo
3 yo
5 yo
7 yo
10 yo

= 2 x BW
= 3 x BW
= 4 xBW
= 5 x BW
= 6 x BW
= 7 x BW
= 10 x BW

MOTOR GRADING

COMPOSITION OF BODY FLUIDS

0
1

Na
Gastric 50
Panc 140
Bile
130
Ileosto 130
Diarrh 50
Sweat 50
Blood 140
Urine 0-100

2
2
3
4

no movement
flicker of contraction with no
associated
movement at a joint
movement present but cant
sustain against gravity
movement against gravity
but not with resistance
movement against some
resistance
movement against full resistance

K
Cl
HCO3
10-15 150
0
5
50-100 100
5
100
40
15-20
120 25-30
35
40
50
5
55
0
4-5
100
25
20-100 70-100 0

Osm = 2 (Na meq/L + K meq/L) +

Urine mg/dL glucose mg/dL
2.8
18

BCE
NB
3-10kg
10.15
15.25
25.35
35.60
> 60

45-50 cal/kg
60-80
45-65
40-45
35-40
30-35
25-30

MF = BCE x Wt x 1.5 = cc/hr

24
or ugtt/min
Fever = +12% for every oC
rise > 37.5oC
Hyperventilation/dyspnea = + 25%
Bronchial asthma = + 50%
Bililight therapy = + 20%

CALORIC REQUIREMENTS
< 1 mo 110-140 cal/k/day
1-11 mos 110-115
1-2 yrs 100-110
3-6 yrs 90-100
7-9 yrs 80-90
10-12 yrs 70-80
13-15 yrs 55-65
16-19 yrs 45-50
PROTEINS RDA
0-5 mos
6-11 mos
1-6 yo
7-12 yo
13-15 yo
16-19 yo

2.5 g/kg/day
2.5-3.0
2.0-2.5
1.5-2.0
1.5
1.0-1.5

Milk Formula
Similac
20 cal
NAN
20
S-26
20
Pre-NAN
21
BM
22
Enfalac
21

CHON
1.5/100
1.5/100
2.25/100
2/100
1.1/100
2.25/100

K infusion rate = IV rate x amt of K (mEq)

Vol of IVF x wt
Normal KIR: 0.1 0.3
Vit K = 0.3 mg/kg for IV antibiotics >7 D
Ca gluconate - 1 cc/kg/shift
Maintenance/ DAY: 30X WT
9
Ca deficit - 53-75 mEq/k/day
Ca requirement - 27-32 mEq/day
Wt x dose
9.8

in 24H

Eg. 75 mEq x 3 kg in 24 H
In q shift = 75 mEq x 3 kg = 75 mEq
3 shifts
= 75 mEq = 8.3 cc = 72 mEq
9
(1 cc = 9 mEq)
Ideal tracheal aspirate: EC <25
PMNs >10
Max steroids for NS : 2 mkD or 60
Mkm 4-6 wks

ALL HIGH RISK PROTOCOL

Anaphylaxis

PHASE
induction
consolidation
maintenance

epinephrine.
1:1000
0.01 mkd max of .5 ml IM

Vincristine 15 mg/m2 on D0,7,14,21

Doxorubicin 25 mg/m2 on D0,7,14,21
Prednisone 40 mg/m2 on D21-25L aspariginase 6mg/m2 for 9 doses
(3 doses per week; mwf/mtw)

diphenhydramine
1-2 mkd IM/IV up to 50 mg q 4-6
Ranitidine
1-2 mkD up to 50 mg IV q 6H
Hydrocortisone
5-10 mkd up to 100-500 mg IV q 4-6H

ANTHROPOMETRY
1. Body Weight
A. Ideal Body Weight
At birth
3000 gms
< 6 mo (g) age in mo x 600 + BW
6-12 mo (g) age in mo x 500 + BW
Nelson's:
3-12 mos
(age in mo + 9)/2
1-6 yr (kg)
age in yr x 2 + 8
7-12 (kg)
(age in y x 7- 5) / 2
B. Expected Body Weight (up to 1 mo)
Term EBW=(age in days-10)
x 20 + BW
Preterm EBW=(age in days-14)
x 15 + BW
Where: 10=time to recover over
physiologic wt loss
20=g/day gained
C. Estim wt
4-5mo 2 x BW
5 yo 6 x BW
1 yo
3 x BW
7 yo 7 x BW
2 yo
4 x BW
10 yo 10 x BW
3 yo
5 x BW

ASTHMA CLASSIFICATION
BASED ON SEVERITY
intrmtnt
day sx <1/w
night sx 2/mo
PEFR exp 80
PEFR var <20
FEV1 80

persistent
mild mod severe
>1/w
>2/mo
80
20-30
80

daily
>1/w
60-79
>30
60-79

daily
>1/w
<60
>30
<60

ATHMA SCORING
WOOD'S SCORE
0
1
2
p02 or
50-100 70 in
70 in
cyanosis
rm air 40fio2
Breath snds N unequal absent
Acc muscles N
mod
max
Exp wheeze N mod
extrem
Cerebal fxn N depresd/coma agitated
1-3 mild asthma attack
4-6 moderate, bedside
7 up severe, intubate

SILVERMAN'S SCORE
0 1
2
Flaring
- min
marked
Lower chest
Retractions - visible marked
Upper chest
Retractions - synch in- seesaw
drawing
Xyphoid
retractions - visible marked
Grunting
steth
ears
(audible)
3-4
7

give 02
intubate

Personal best Predictive Value of PEF

females: ht(cm) - 100 x 5 + 175
males:ht(cm) - 100 x 5 + 170
actual PEF >80%, normal

CHF CLASSIFICATION
*Anatomic
I
II

acquired
congenital

*Physiologic (disturbance in)

A heart rhythm and conduction
B myocardial contraction
C clinical syndrome (HPN,DM)
*Functional
I asymptomatic
II symptomatic w >ordinary act
III symptomatic w minimal activity
IV symptomatic at rest
*Therapeutics
A no restriction of act
B restriction of severe act
C restriction of moderate act
D sharp restriction of ordinary act]
E complete rest in a chair or bed

MILK
Abbot,wyeth = 1:2
MILK
alfare
bm(t)
bm (pt)
bonna
caro syr
corn oil
enfalac
gain
lactum
nan1
nan ha
neosure
nutren jr
prenan
promil
s26
s26lbw

CPAP GUIDELINES
MJ & Nestle = 1:1

CAL CHON g FAT CHO

72/dL 2.5
3.6
7.8
699/L 9.09 41.96 72.7
75/dl
1.1
4.5 20/oz
671/L 14.09 38.93 66.4
22/oz 1.1/dl
120/oz
31
813/dL
82
67.6/dL 2
3.5
7.4
21/oz 2.25/dl
22/oz 2.8g/dL
21.4/oz 3.42g/dL
67/dL 1.2
3.6
7.5
20/oz
1.5/dl
67/dL 1.51
22/oz
100/dL 3
3.9
13.3
80/dL 2.3 4.2
8.6
21/oz
2/dl
81/dL
2.4 4.1
8.9
20/oz
2.25/dl
100/
2.4/dL
125ml
24/oz

1. Initially CPAP is set @ 6cm water. If

there is no inc in PO2 in 15 min
pressure must be increased in 2cm
increments to a maximum of
10cm. (If by ETT) or by 12cm (in
other method).
2. If there is an increase in PaO2,
reduce pressure.
3. If 10-12cm water pressure is
attained and if PaO2 reamins
under50, FiO2 must be increased
by 5-10% increments.
4. CPAP failure is evident if PaO2
remains less than 50 in 100% FiO2
with 10-12cm water.
*If CPAP fails under non invasive
method, an ETT must be inserted.
*If CPAP fails w/ ETT, mechanical
ventilation is indicated.

Parameters To Be Met B4 Weaning

1. Improvement in CXR
2. AABG showing PO2 >/= 50 mmHg
3. Blood PH >/= 7.3
4. PCO2 </= 55 mmHg
5. Hgb 12-15g% or Hct 36-45
Weaning from CPAP
1. Decrease FiO2 by 3-5% every time
PaO2 > 70
2. With FiO2 of 40%, reduce pressure
by increments of 2 cm water every
2-4H until pressure of 2-3cm
is achieved.
3. transfer ptient to oxygen hood
with FiO2 of 15-50%

CSF Normal Values

OPENING Pressure
Newborn
80-110 mm H2O
Infant
<200 mm H2O
GLUCOSE
Premature
Term
PROTEIN
Premature
Term
WBC ct
Premature
Term

24-63 mg/dl
(csf-bld ratio 55-105%)
44-128 mg/dl
(csf-bld ratio 44-158%)
65-150 mg/dl
20-170 mg/dl
0-25 /cumm
(57 % PMNs)
0-22 /cumm
(61% PMNs)

ELECTROLYTE COMPUTATION
I. POTASSIUM
normal =4-5.6 meq (4)
N K deliverance = 0.1 - 0.4 meq/kg
Deficit = (KD-KA) x wt x 0.6
Maintenance K= 2 x wt
Total K def = deficit + maintenance
Full incorporation: 40meq/L or
20meq/500cc
K INFUSION RATE
K delivery = ivf rate x K in ivf / vol/ wt
normal=0.2-0.4meq/kg
II.SODIUM
maintenance Na=3 x wt
maximum target/day=10 meq
Na = 1 mEq = 2.3 mg/dl
K = 1 mEq = 3.91 mg/dl
NaHC03= gr x=650 mg=7.7 meq
gr v=325
III. CALCIUM normal = 8-10 meq
IV. CHLORIDE normal = 98-106 meq
V. CO2 normal = 15 meq

ET Tube Sizes and Distances

According to Infant Weight
Weight (gms)
500-1000
1000-1400
1400-1900
1900-2200
2200-2600
2600-3000
3000-3400
3400-3700
3700-4100
4100-4500
>4500

l.D. (mm) Depth (cm)

2.5 N
7.0
3.0
7.5
3.0
8.0
3.5
8.5
3.5
9.0
3.5
9.5
3.5
10.0
3.5
10.5
4.0
11.0
4.0
11.5
4.0
12.0

DOUBLE VOLUME EXCHANGE

TRANSFUSION
= KBW x EST. Blood vol. x 2
materials:
1. NGT fr. 5 #1 (umbilical cath.)
2. Three way stop cock
3. FWB
4. suture
5. 50cc syringe
6. Ca gluconate
7. HGT strip

EFW
station
fundic ht (in) - 13 x 155
12
11

0
+

normal wt for term: 2500-3800 g

Naloxone
Narcan cc=0.1 x efw
----------------0.4
given to bb whose mothers were
given Demerol with in 4 hrs PTD
LBW
VLBW
ELBW

2000-2499
1500-1999
1000-1499

GROWTH
I. WT GAIN
age
wt gain
(g/day)
0-3 mo 30
3-6 mo 20
6-9 mo 15
9-12mo 12
1-3y
8
4-6y
6

length
(cm/mo)
3.5
2
1.5
1.2
1
3/y

hc
cm/mo
2
1
0.5
0.5
0.25
1/y

II. Nails
1cm/3mo
III. Hair
1cm/mo
IV. Liver span
1 w : 4.5 5 cm
12 yo : M 7-8 cm F 6-6.5
>12 yo: M: 0.032 x wt(lbs) + 0.18
x ht (in) - 7.86
F: 0.027 x wt + 0.22 x ht - 10.75
V. Gallbladder
length
infants: 1.5-5.5 cm
adolesc: 4-8 cm
width
neonates: 0.8 cm

all ages : 0.5-2.5

AGE
GROUP

FREQUENT PATHOGENS (IN ORDER OF

FREQUENCY)

Neonates
(<1 mo)

Group B streptococcus, Escherichia coli, other gramnegative bacilli, Streptococcus pneumoniae, Haemophilus
influenzae (type b,[*] nontypable)

13 mo
Febrile
Respiratory syncytial virus, other respiratory viruses
pneumonia (parainfluenza viruses, influenza viruses, adenoviruses),
S. pneumoniae, H. influenzae (type b,[*] nontypable)
Afebrile
Chlamydia trachomatis, Mycoplasma hominis,
pneumonia Ureaplasma urealyticum, cytomegalovirus
312 mo

Respiratory syncytial virus, other respiratory viruses

(parainfluenza viruses, influenza viruses, adenoviruses),
S. pneumoniae, H. influenzae (type b,[*] nontypable), C.
trachomatis, Mycoplasma pneumoniae, group A
streptococcus

25 yr

Respiratory viruses (parainfluenza viruses, influenza

viruses, adenoviruses), S. pneumoniae, H. influenzae
(type b,[*] nontypable), M. pneumoniae, Chlamydophila
pneumoniae, S. aureus, group A streptococcus

518 yr

M. pneumoniae, S. pneumoniae, C. pneumoniae, H.

influenzae (type b,[*] nontypable), influenza viruses,
adenoviruses, other respiratory viruses

18 yr

M. pneumoniae, S. pneumoniae, C. pneumoniae, H.

influenzae (type b,[*] nontypable), influenza viruses,
adenoviruses, Legionella pneumophila

ANTI-AMOEBIC
Metronidazole

35-50 mkD (7.5 mkd)q8

< 7 or <1.2kg = 7.5 mkDq12
> 7 or > 2 g = 30 mkD
Flagyl
PO: 125/5; 250
Servizole
200mg/5mL
Etofamide 15-20 mkD
Kitnos
40/5; 250; 500
Cotrimoxazole
Clindamycin

6-20 mkD bid (TMP)

<7d.o./<2kg:10mkD
10-40mkDq6-8
Dalacin C
75/5ml
Chloramphenicol 50-75 mkD
Chloromycetin
Tetracycline
40-60 mkD

Other Antibiotics

Antacids

GLUCOSE INFUSION RATE

ciprofloxacin

Cimetidine
10-20 mkD
Tagamet syr 200mg/5ml;
100mg/5mL

GIR: RATE X DEXTROSITY

WT X 60
PERIPHERAL LINE: 5-6 CENTRAL LINE 9-12

Ranitidine 4-5 mkD q 8

Zantac IV 50 mg/2mL
PO 150mg; 300 mg

Dextrosity d5
50
D 7.5 75
D10 100
D50 500

10 mkd q 12 hrs

Co-trimoxazole 8-10 mkD BID (based on TMP)

Triglobe 45 mg/5mL
Bactrim 160 mg/5mL; 40
mg/tab; 80 mg/tab
Macrobid 40mg/5 mL
Clindamycin :

30 mkD for osteomyelitis

30-50 mkD q 8 or 6
Granules: 75mg/5mL 150/mL

Omeprazole 0.6-0.7 mk OD
Losec 20 mg/tab; 40 mg/tab
Famotidine 0.7 mkd q 12
H2Bloc 20mg/2mL

Converwsion:
Conc desired-actual x 2
1000

x total vol

Eg: d10- d5x2= 0.1

Chloramphenicol
Chloromycetin
Chloramol

50-100 mkD

Tetracycline 40-60 mkD

Lanzoprazole

15-30 mg/24 hrs

25 mg OD PO
Prevacid FDT

Anti emetic
Metoclopramide 0.1 mkd q 8 hrs

Conversion: d7.5= 0.055

D10= 0.11
Calories:

D5
D7.5
D10
D12

0.2 kcal/cc
0.3
0.4
0.5

PULMONARY VOLUMES

BLOOD TRANSFUSION

ACTUAL RETIC COUNT (ARC)

1. Total Volume (TV) = 500 mL

= volume inspired or expired with
each normal breath
2. Insp. Reserve Volume (IRV) = 3.0 L
= volume that can be inspired over
and above the TV
3. Exp. Reserve Volume (ERV) = 1.1L
4. Residual Volume (RV) = 1.2 L
= volume that remains in the lungs
after maximal expiration
5. Dead Space = 150 mL
a. Anatomical: volume of the
conducting airways
b. Physiological functional
measurement; volume of the lungs
that does not eliminate CO2
(usually greater in lung diseases
with V/Q inequalities)

FWB

Actual Hct
Desired Hct

20 cc/k (max)

Vol = desired actual Hb x 6 x Wt

= desired actual Hct x Wt
rate = vol x 12 gtts/mL
60 min x 4h

x reticulocyte ct

RETICULOCYTE INDEX = Arc / 2

= Hct / ret ct x 2

= gtts/min

10-15 cc/k
15 cc/K in neonates
Vol = desired actual Hb x 2 x Wt
= desired actual Hct x Wt
Desired Hct = volume/wt + Actual Hct

> 2 = hemolysis
< 2 = BM suppression

PRBC

DOUBLE VOLUME EXCHANGE

TRANSFUSION
= KBW x estim body vol x 2

Sedimented RBC

15 cc/k
PARTIAL EXCHANGE TRANSFUSION

Platelet Conc:
1 U / 6 KBW
1U = 30-50 cc (raises platelet ct by 10T)
FFP = Fluid rate (5-20 cc/k/h in 4h) 1O-15
CC/KG
CRYOPPT: 1 UNIT/7 KG

= KBW x estim vol x Hct A-D

Actual Hct
1 u = increases Hgb by 2; Hct by 3

Insulin Drip

DOPA- DOBU COCKTAIL

Secure regular insulin (100 iu/mL)

Prepare as follows:

1. aspirate 0.1 mL from vial + 0.9mL NSS to make

10 iu/mL
2. aspirate 0.1mL from (1) + 0.9 NSS to make
1 iu/mL
Start dose at 0.05 iu/ k/ H
Ex. Weight 1.55 kg
1.55 x 0.05 = 0.08 mL/H
Calculate for vol nedded in 8 hours
0.08mL x 8 = 0.6 mL
Instructions: aspirate 0.6 ml from (2) + 7.4mL to
make 8 mL and run at 1 mL/ hour

Get rate of dopa according to desired dose

Get volume of dobu according to desired
dose using
Vol= __wt x RD x 60__
Dopa rate

conc. of dobu

Eg.: wt 3kg , Dopa 15, Dobu 15

Dopa
1 cc
Dobu
0.8 cc
D5Water 48.2 cc
50cc at 3.4 cc/hour