Neonates( AGE& Heart&beat& Respi& Fluids/Nutrition(

Rate&
Weight& Premature& 120-170( 40-70( & TERM& PRE;
BW=(3,000gms( TERM&
<6&mos:& 0;3mos& 100-150( 35-55( D1& 60-65cc/kg( 75/80(
((wt(gms)=((age(in(mos)x(600+(BW(
6;12mos:( D2& 80cckg/( 80-90(
3;6mos& 90-120( 30-45(
(((wt(gms)=((age(in(mos)x(500+(BW( D3& 110-120cc/kg( 95-110(
1;6&yo:& 6;12mos& 80-120( 25-40( D4; add(increments(of(10( 110-120(
(wt(kg)=(age(in(years(x(2(+(8( 6&
1;3yo& 70-110( 20-30(
6;12&yo:&& D5& 130-140CC/kg( 120-130(
wt((kg)=(age(in(years(x(7(+5(/(2.2( 3;6yo& 65-110( 20-25( D6& 140-150( 130-140(
Length((ave:(50cm(or(20(inch)(
(((((Birth-(3mos( 9cm( 6;12yo& 60-95( 14-22( D7& 100cc/kg( 100(
(((((3-6mos(8cm( (
(((((6-9mos(5cm( >12yo& 55-85( 12-18( Dextrosity:(
(((((9-12( ( 3cm( D5=x(0.05(
& D10=(x(0.10(
For(>1yo(
& D50=((x0.50((
Ht(in(cm=(age(in(yrs(x(5(=80( (
&
((((((In(inch=(age(in(yrs(x(2(+32( (D10W&or&D25W)&
&
Head(circumference( Emergency(resuscitation(
& -(give(glucose(250&;500mg/kg(infused((
((((((Birth-(4(mos.(¼(in(mos(
( (((over(1-2min(
Waterlow&classification:&&
BP( &
&Actual(weight(((((X(100( Age(in(yrs(x2(+(90((upper(limit)( Diabetic&Diet:(BSA(x35(cal/k/d(
Ideal(wt(for(actual(length/height( Age(in(yrs(x2(+(70((lower(limit)( eg.70cal/k/d(
Normal:(>90%( nelsons( wt-7.5kg(
Mild:(80-90%( ( 7.5x70=525(
Moderate::(70-80%( (
( &
Severe:(<70%& 60%(CHO(-525(x.60=(((/4=80gms(
(
20%(CHON(-525x.20=(/4=20gms(
Actual&height/length&X100& (
20%((Fat(-525x.20=(/9=12gms(
Ideal&length/height&for&age& (
(
Normal:(>95%( &
Total&Parenteral&Nutrition&
Mild:(90-95%( &
(protein/amino(acids)(
&
Moderate::(80-90%( wt((dose)((prep(7-9%)(
Severe:(<80%& (
Respiratory&rate& Age&
Calcium(
( <&60&& (<(2mos( =&wt.&x&200/100/&#&of&cycles&
Ideal&Body&Weight& &
<&50&& (2-12(mos(
Birth-3(mos( age(in(mos./2(+(3( CALORIES&
3-12(mos( age(in(mos(+(9/2( <&40&& 1-5(yo( EBM-(20cal/1(oz(
1-6yo( ( age(in(yrs.(X(2(+(8( Preterm-24cal/1(oz(
<&30& 6-8(yo(
(
7-12yo( ( age(in(yrs(x(7-5/2(
& GIR=(Dex&X&TFI&/&dex&X&rate&X&0.167(
Ideal&Height&(cm)& ((((((((((&144&& &wt.&
& RR& HR&
=age(in(yrs(x(5(+(80(inches( &
& & &
=(age(in(yrs(x(2(+(32( (
NEONATE& 45-60( 120-160(
( 2;6mos& 40-50( 130-140(
Height:(at&birth&& &&&&50&cm& (
&&&&&&&&&1&yr&old&&&&& &&&75&cm& & <1yr& 30-40( 120-130(
&&&&&&&&&2;12&yr&old&&&(yr)&x&6&+&77&
>1yr& 20-30( 90-110(
& (
&
( &
( & (
&
( &
& & (
& &
& & (
& &
(
Per&1L& Na& K+& Cl& Ca& (
(
D5LR&&&&&&&& 130( 4( 109( 1.4(
( (
D5&.3N&&&&&&&& 51( -( 51( (
D5&.45N&&&&&& 75( -( 75( (
(
( (
D5&.9N&&&&&&& 154( -( 154( (
D5NR&&& 140( 5( 98( ( ( (
D5NM& 40( 13( 40( ( ( ((
D5IMB&&& 25( 20( 23( (
Fluids/Electrolytes( Neurology(
Total&body&water&(L)&=&0.61&x&wt(Kg)&+&0.251( GLASSGOW(COMA(SCALE(
Plan&A& Give&as&much&Fluid&
( & than&usual&
Dehydration( 50;100ml&
Eyes& & 4((Spontaneous&opening&
<2yo&
Maintenance&Fluid&(Holiday;Segar)& & 3&&To&speech/command&
&
<10( =100cc/kg(in(24hr( 2;10yo& 100;200ml& 2&&To&pain&
>10-<20( =excess(X(50(+1,000(in(24hr( & & 1&&NIL&
>20( =(excess(X(20(+(1,500(in(24(hr( older&children& as&much&as&they&& &
( want&
Oral(rehydration(solution:( Verbal& 5&&Coherent/oriented&
Wt&x&75cc&for&4hrs( Plan&B& & & & 4&&Confused&
0-2yo( (50;100cc/lbm( Mild&and& 75cc/kg&in(4h( & & 3&&Inappropriate&words&
2-10yo( 100;200cc/lbm( Moderate& ( 2&&Incomprehensible&
>10yo( as(much(as(tolerated( 1&&NIL&
& Plan&B& 100cc/kg& Motor& 6&&Follows&Command&
Oral&Rehydration&Solution& Severe& 30cc/kg(((((1st(hr( 5&&Localizes&w/&pain&
Oresol&&&Glucolyte&&Pedialyte& 70cc/kg((((((5hr( 4&&withdraws&w/&pain&
&Na& ((((50( (((((50( (((((((((30& &
& 3&&decorticate&(flexion)&
&K& &&&20( (((((20( (((((((((20& 30cc/kg(in(30(min.(
<&12mos&& 2&&decerebrate(extension)&
&Cl& &&&50( (((((42( (((((((((30& 70cc/kg(in(2hr.(30min(
>&12mos& 1&&NIL&
HCO3& ((((30( (((((28& &&&&&&&&;&
Gluconate&;& &&&&&5& &&&&&&&&;& (
Mg& &&&&;& &&&&&5( ((((((((((4( Malnourished&to& ( Modified&coma&scale&&for&infants&
&&&&&& &run&in&8hrs& ( Eye(opening( (((((((((score(
(( Severe&(PLR)& Wt.×30cc( (Spontaneous( ( (4(
( <&1yo& in(1hr( (To(speech( ( (3(
Hypotonic&& Hypertonic&& ( &>1yo& in(30(min( (To(pain( ( (2(
D5NM( ( D5W( ( (None( ( (1((
D5W( D10W& (
D5(0.3NaCL( ( Verbal(
Isotonic& ( Coos,(babbles((( (5(
D5Maintresol( ( Irritable(cries(( ( (4(
D5IMB,isolyte& D5LR(
PLR( ( ((Respiratory( (Cries(to(pain( ( (3((
D5NSS( ( 1. O2Lpm__X(4(+(2(=(FiO2( Moans(to(pain( ( (2(
PNSS& ( 2. FiO2(X(5( None( ( (1((
Room(air:(O2(<(80%(hypoxemia( Motor(
No&signs& &&&&&&& Some& Severe& (N(spont.(Mov’t( (6(
60-70%(mild(
Well,&alert& Restless( Lethargic( (Withdraws(to(torch( (5((
40-59%(mod(
Irritable( unconscious( (Withdraws(to(pain( (4(
<40%((((severe(
W/&tears& & Dry,sunken( Very( dry( ,( (Abn(flexion( ( (3(
very(sunken( (Abn(extension( (2(
(( (None( ( (1((
Moist& Dry( Very(dry(
mucosa& Thirsty( Drinks( (
poorly( ( 1-2(diencephalon(
goes& back& Goes( back( Goes( back( 3-4(midbrain(
quickly& slowly( very(slowly( ( (((((((((((((& 5-8(pons(
( 9-12(medulla(
&
Mannitol(
( FiO2=&(CA&X&21)&+&O2(100)&&
((((Preparation:(20(gm/100(mL(
CA&+&O2&
((((Dose:(0.5(-(1(gm/kg(or(2.5(mL(to(
((((((((((((((5(mL/kg(q(6(hrs.(
(
(
( Benign(febrile(seizure:((
Diazepam(prophylaxis)-(0.8;1mkday(q8(
( Post;Lumbar&
Use(gauge(23(needle(
( 1. Flat(on(bed(x(4hr(
2. NPO(x(4(hrs(
3. VS(q(hourly(
( 4. Bottle:(
a. Cell(differential(count(
b. Protein/sugar(
( c. GS/CS,(india(ink(
d. AFB(
( e. Bacterial(antigen(
5. Watch(out(for(bleeding/((
((((change(in(sensorium(
( 6. Hgt(

(
 m2=&&&&ht&(cm&)x&wt(kg)& 2. Start( therapy( after( hydration:( Dissolve& 1& gm&
CRANIAL&NERVES& &
&&&&&&&&&&&&&&&3600& (20mkday)(cylophosphamide(in(50cc(water(and(
CN(I( Olfactory( Smell( & add(to(D5W(to(make(80cc(soln.(To(run(for(4hrs(
CN(II( Optic( sight( TFR:( 3. May(give(anti-emetic:(Ondansetron(2hrs(prior(to(
BSA:({(wt(x(4)(+7}(/90(or( tx(
CN(III( Occulomotor( EOM( =(wt(X(4(+(9/100(((Dr.(Villanueva)( (
CN(IV( Trochlear( EOM( Oral&fluid&limitation:( Chronic&GN:&
=((BSA(x(400)(+(UO(for(24hr)( 1. dipyridamole(tab(persantin)(
CN(V(( Trigeminal( Mastication( (=(BSA(x(400)(+(½(UO(if(w/(furosemide( 2. prednisone(tab(every(other(day(p(breakfast(
Sensory( ( 3. fish(liver(oil(
CN(VI( Abducens( EOM( if(urine(output(not(known=(BSA(x(500( 4. INH(
CN(VII( Facial( symetry( ( (
Estimated&GFR((=[(0.5)((ht(cm)( UTZ(guided((RUS(50200)(
CN(VIII( Cochlear( Hearing( (crea(Umol/L)(x(100( 1. UTZ(done(and(site(located(
CN(IX( Glossopharygeal( Gag(reflex( ( 2. Xylocaine(1%(infiltrate(on((site(
Insensible&loss:(
CN(X( Vagus( Vocal( 3. 1cm( Incision( done( with( surgical( blade(
BSA((500)(+(UO((24)(+(10%((
paralysis( ( #1(
CN(XI( Spinal(Accessory( shrug( Na(limitation((2-3(meq/17)( 4. Spine( needle( g25,( used( to( probe( kidney(
=(2(x(wt(x(23( and(det.(the(exact(depth(
CN(XII( hypoglossal( Tongue(
deviation( Total(protein((mg/hr)( 5. Kidney(biopsy(needle(insert(2x(
[9/24(x(1000/24]/(BSA( Specimen( for( immuno-flourence(
& ((If(((>40,(nephrotic( collected(and(LM(
& (
ADEM( LM-((((((((((((((((((((5,750(
Bladder(capacity(=age(yr(x(2oz(x(30(
IV(Ig=(400mkday(x(5(days( PF-(((((((((((((((((((((2,900(
(
Specimen(for(IM((((((100(
& Normal((bladder(residual;(,5cc(or(10%(
FAX(((((((((((((((((((((((((60(
Mannitol( (bladder(capacity;(if(↑,(risk(of(UTI(
( (((((((((((((((((((((((((((8,850(
((((( Preparation:(20(gm/100(mL(
CREATININE&CLEARANCE& Light(microscopy(((((((((15860(
( Dose:(0.5(-(1(gm/kg(( IM(
( or(2.5-5mL/Kg(q(6(hrs( Kilo(in(gms(
Creatinine(in(mg/dL( Electron(microscopy(
( Fax(((((((((((((((((((((((((((((((((90(
Constant:(0.55(
Benign(febrile(seizure:(( ( (((((((((((((((((((((((((((((((((15,950(
Diazepam:0.8;1mkday(q(8( example:(138(gms( Dr.(Sonia(Chicano(
(prophylaxis)( ((((((S.(crea=(572(µmol/L( Histopathology(dept(
Sodium&Valproate:&wt&X&vol.&distr.&& To(convert((µmol/L(to(µg/dL( National(kidney(institute(
& & &&&&&&&&(desired-(actual)( (((((572/88.4=(6.47( East(ave.,(quezon(city(
& ( (
Urine(culture( ((((0.55(138(gms)/(6.47=(11.7( Prepare:&
Suprapubic:&& Growth(in(any(#( Creatinine(Clearance( &Newspaper(
2;3&x103&CFU/ml& (((((K)(((height(in(cm()((/(mg/dl=(?( (Petri(dish(
Catherization:&& febrile(infants/children( ((((*answer(is(in(ml/min( (Medium(size(icebox((rectangular)(
&&&&&&&50,000&CFU/ml(evidence(of(single(( ( (Packaging(tape(
(((((((((urinary(pathogen( normal(value:((26;&78&ml/&min& (Pentel(pen(
MSSC:&sxtic:(105CFU&Asxtic( (At(least( normal(serum(crea:(53;&115&mmol/L& (4kg(dry(ice((toril(fish(port)(
(((((((((((2(specimen(on(diff(days(105CFU( K(-(constant( Mailing(envelope(
& ((((LBW(Infants( ( 0.33( (
DIALYSIS:&25;50mL/kdose& ((((FT(infants( ( 0.45( (
((((Child(( ( ( 0.55( &
Infusion(time:(10-15min(
((((Adolescent(girl( ( 0.55(
Dwell(time:(30min(
Drain(time:(10-15min( ((((Adolescent(boy(( 0.70(
Volume(of(Dialysate=(30X(wt( (
Incorporate(Heparin(1:5,000u/mL( Fluid(for(AGN(
(((((2mL/(bag)( D1=75%(of(TFI(
Incorporate(KCL(4mL/2L(bag(( D2=prev.(24(hr(urine/2+400(BSA)(
((((aftr(10th(exchange( Osmolality((
GS/Cs(q(other(day(if(cloudy( (serum(Na(+(K(x(2)(+(glucose(÷(18+(BUN(mg/dl(÷(3(
(
Do(s.(electrolytes(
Creatinine(on(12th,(24th,(( Methlyprednisolone(therapy:(
((((48th,(60th(exchange( (500mg;1gm&(30mkdose)((
& Methlyprednisolone&therapy:((
& DAT(
CBC,(UA(
&
Start(IVF(w/(D5W(500cc(at(KVO(rate(
&
For(methylprednisolone(tx(500mg(IV((
Nephrology(( (((OD(x(3doses(
Body&surface&area&
dissolve(500mg(of(methylpred(in(20cc(
0-5(kg=(wt(x(0.05(+(0.05(
6-10kg=(wt(x(0.04(+(0.1( (((diluent,(then(add(to(make(a(80D5W(
10-20kg=(wt(x(0.03(+(0.2( (((to(make(100cc(soln.(X(4hr(at((
20-40(kg(=(wt(x(0.02(+(0.4( ((20cc/min(x(3(doses(
( (
or( Cyclophosphamide&infusion:&&
( 1. Hydrate(x(4-6(hrs:(D5W(
& Dopamine(800,(1600( ACE:& Captopril&:&
Sodium& Dobutamine(2000( &0.1;0.5mkdose&&&TID&&&&&&&&&&&&&&&&&
( (max:&6mkday)&
& =(desired-actual)X(wt.(X(0.6&&&& =&&&Wt.&x&60&x&dose& ( Enalapril:&
&&&&&&&&&&&&+&&&&&&&&&( Preparation& ( &0.08mkady&QID/BID&
*Maintenance:(Wt.(x((2-3)( ( &&&&&(max0.6mkday)&
Drip:(TFI(X(wt=1000ml/desired( (
Dobutamine(infusion:( Diuretics& Furosemide:((
((((IVF(composition(
(0.5;2mkdose(QID/BID((
& 6(mg(dobutamine(x(Wt.(=(mg(+(diluent(to(create(a(
(Oral:((1;3mkday&
Magnesium&&(500mg/ml)& solution( to( total( of( 100( cc( infusion( of( 1( mL/kg( &&&&&&&&&&(max(6mkday)(
& IV(=25;50mg/kg/dose(+(D5W( delivers(1(ug/kg/min( (IV:((0.5;1.5mkdose(
& _cc(x(3(doses(to(run(2-20hr( & (Drip:&
PO=100-200mkdose(QID( Digitalization& ((=(Wt(x(dose(÷preparation((
( 1st((&&Wt&x&0.4=& ((((make((soln((to(run(x(24h((
Max.(single(dose-(2(gm( 2nd(&&0.8÷&4=& Vasodilator& Hydralazine:(75mkD(
Max(Infusion(rate:(1meq/kg/hr( 3rd(((&0.2&÷&0.05=&
( & (
Toxicity:& (Dr.(Villanueva)( (
>3mg/dL-(CNS(depression( Newborn(0.03&mg/kg/day( Murrmur& Type& defect& (
>5mg/dL-(dec.(DTR’s( Children(0.04&mg/kg/day( (
Systolic& HSM( VSD(
>12mg/dL-resp.(paralysis,( Loading:(1/4th(TDD(q(6(hrs.x(4(doses( (
PSM( MR(
(((((((heart(block( Maintenance:(1/10th(TDD(x(20(q12hrs.( (
TR(
& (Dr.(Paragas)( (
SEM( PS(
& ( Mx:(wt(x(0.004/0.05(( (
AS(
Bicarbonate&Replacement& ((((((((((((((Or(wt(X(0.04/10(X(20( (
Diastolic& Diastolic( MS(
& a. Base&deficit&x&wt.&x&0.3& ( (
rumble( TS(
Half(correction:((Give(1/2((( Ped(elixir(0.05mg/ml( (
Diastolic( PR( (
((initially((then((check((ABG( Tab(0.25mg( blow( AR( (
b. 1-2meq/kg(and(give(½((of(((((((( Amp:(0.5mg/2ml(
computed(Dose( Continuou ( PDA( (
(
(((((Give(as(slow(IV(push(+(( s&& Systoli
L-carnitine(carnicor)-10mkdose(
((((((((((((((equal(amt.( c-(Holosystolic/Pansystolic(
( (
LDH& &100;190&
& Intensity(( (((((Description( (
CPKMB& &7;24&
Calcium&(9%&elemental&Ca)& I/VI(((Barely(audible((
SGOT& 10;35&
& - symptomatic(hypocalcemia( ( II/VI((Audible(after(a(few(seconds(of(auscultation,(low(
- acute(treatment:10%calcium( P&D&A:& intensity((
gluconate(100;200(mkdose(( Functional(closure(:10;15hrs&after(birth(
((((((1-2(ml/kg/dose)( Anatomic(closure:(2;3wks( III/VI( Immediately(audible,((
=&wt&x&(200;300)/prep&(500)( ( &&&&&&&&&&&&&&&&&&&moderate(intensity((
! Give(Ca(gluconate(+(equal(( ( Kawasaki((disease(
(((amount(of(diluents(to(run(for( IV/VI( Loud(intensity(without(a((
(((1-2hr.q(6h(x(___doses?((( ( IV&Ig& (
&&&&&&&&&&&&&&&&&&&precordial(thrill (
(((((((Or(1;2cc/kg(
(
2gms/kg___(
Secure(__gms(of(IV(Ig(to(transfuse(as(ff:(
V/VI ( Loud(intensity(with(a((
Maintenance(treatment:( 1. Test(dose:(0.5&×!wt=____cc(run(in( &&&&&&&&&&&&&&&&&&&precordial(((thrill ((
10%(calcium(gluconate(( 30min.( VI/VI( Loudest(intensity,(precordial((
((iv(or(po)(200-800mg/k/day(( 2. Test(dose:(1& &wt.=____cc(run(in(30(
((((2-8(ml/kg/day)( &&&&&&&&&&&&&&&&&&(thrill,(audible(with(stethoscope(slightly(away(
min.(
Max.(Infusion(Rate:( ( from(thoracic(wall(
IV(push-don’t(exceed(100mg/min( 10gm/200cc(
IV(infusion-do(not(exceed(( 5gm/100cc( NELSON:(
((120-240mg/kg/hr(with(a(( 2.5gms/50cc( contains(100mg/ml(of(Ca(Gluc-(is((
(((max(conc.(Of(50mg/mL( Give(remaining____(for(12hr(x(cc/hr( equal(to(8.9mg/ml(or(0.45mEq/ml(
& ( (of(Calcium.(
ANION&GAP:&NV;&12+& ( Aspirin(initially( (
& & -high(dose:(80;100mkday(q8-6hr(then( Give1-2cc/k/dose(or(
=&(Na&+&K)&–&(Cl&+&HC03)& -( low( dose:& 3;5mkday& after( fever( ((((((((0.45-0.90(mEq/k/dose(
& settles)(x(6-8(wks( ((((((((daily(dose(may(be(as((
& (To( stop( if( no( coronary( artery( ((((((((high(as(2.7mEg/kg/24hr(
Potassium& aneuryms( (((((preparation(
( 10%(injection:((9.3(mg/ml(or(.46((
& =&(desired;actual)&(wt&)x&0.4&&
( mEq/ml(elememtal(calcium(
&&&&&&&&&&&&&&+((
( osmolarity((:((700(mOsm/L((
((((((((Maintenance(=(wt(x((3)(
Anti-hypertensive( ( (
Dr.(Manalaysay:((K=&5&&&&X&&&&WT&
&
K+(delivery(:(0.02-0.4(
Not(to(exceed(>0.4/hr(in(cc/hr(
(
KIR(=(meq(K+(X(rate/wt(
(((((((Total(IVF(vol.(
Banana/kalium(durule=10meqs(
(
Cardiac&
Medication/& Dose&(mcg/k/hr)& Umbilical&Catheter& Wt(x(dose(x(preparation((10-20%)(
Preparation& =&wt&X&4+&9& e.g(=&wt&x&0.5&x&100&
2& &&&&&&&&20&
Calcium& Mx:(100;200& Dose:( (0.5(g(/kg-3g/kg(
100mg/ml& IV(push:(<100mg/min( ET&size& Order:( (intralipid(20%-(ml(to(run((
IV(infusion:(120;240mg/kg/hr( Age&+&4& ((((((((((((((((((x(16(hrs(
(((Max:(50mg/mL( 4& (
Epinephrine& 0.01;0.03mg/kg&or&& prep:(10gms/100ml&
(
5mg/ml&(5,&10ml)& 0.01ml/kg(of(1:10,000-asystole( dose:((starts(at(1&gm/kg(
(
0.1;1mcg/kg&-(IV(drip& To(compute:(
Solumedrol&
0.5ml/kg-(croup( wt(X(gms(needed(X(100/10/8((
Dissolve(1g(in(200ml(of(diluents(
( ((((=(amt(in(ml(to(be(given(q(3(
((((In(soluset(
1ml&+&9cc&d5w&(:100)& (
Add(80cc(of(D5W(to(make(100cc(
Fentanyl& 1–5&mcg/kg& (((To(run(in(4hours(at(25cc/hr( Richard's&solution:(
100mcg/2ml& & Start(D5W(at(KVO( ex:(wt:(0.9(kg.(
Wt&X&dose&X&24hr& Off(mainline(IVF(while(on(( 1gm((÷((kg((x(0.9(kg=(0.9gms.(
Insulin&& 0.05u/k/hr&<2yo& (((Solumedrol((Infusion( how(many(ml(to(be(given:(0.9g=(
0.1u/k/hr&&&>2yo& Rpt(solumedrol(therapy(q24hrs( ((((((10gms(÷(100ml=9(ml/day(
5’u’(in(50cc(PNSS(at(20cc/hr(( (((X(2doses( How(should(it(be(given(in(q(3(hrs?(
(0.1u/cc(for(20kg)( Monitor(bp(q30min( 9ml/day=1(day(/(24(hrs=(0.375(ml/hr(
Wt&X&dose/prep& & 0.375(ml(x3(hrsw(=(1.125(ml(q(hr(
Levophed&(NorE)& 0.05;0.1mcg/k/min( ( (
1mg/ml&(4ml)& Max:(2mckd( ( Vamin(
( CORTICOSTEROID&(5&DAYS)& Wt.&x&(0.5;2)/9&x&100/&24hr&
1amp(4mL)&+&16ccD5W&(:200)& Hydrocortecosteroid(
Midazolam& Intermittent( IV(expznders((NSS/LR)( Hepamerz:(4&amps&+&200cc&D5W&&
1mg/ml& 0.05;0.15mkdose& O2(inhalation( &&&&&&&&&&&&&x24hr&OD(
5mg/ml& IV(infusion( Glucagon(1-5mg(IV(ff(by(infusion( (
& 0.5mcg/k/min(<32wks( ((((5-15mg/min( Ideal(body(weight(for(the(day(
& 1mcg/k/min&&&&>32( Atropine(SO4(0.3-0.5mg(IV( Birthweight:(
1;2mcgkg/min(infant/child(( ((((((max(2mg)( (((((-((((10%(of(birthweight((
( Neb(w/(bronchodilator( ((((--------------------(
1amp(1ml)&+&19cc&D5W&(:250)& Dopamine( ((((corrected(body(weight:(
Magnesium&SO4& IV/IM:( & [§(note:(physiologic(weight(loss(in((
500mg/ml& 25;50mkdoseq4-6hx3-4dose( & ((((((((10(days](
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Max(infusion(rate:(1meq/kg/hr( & ((((actual(age(in(days:(
Nicardipine& 10mg(nicardipine(+(D5W(cc(to(run(at((( & ((((-(10(days((for(physiologic(wt(loss)(
10mg/amp& 5-10cc(and(titrate(to(5cc(q(30min.((to( & ((((------------------(
max(at(30cc/min( & ((((corrected(age(in(days:(
Dr.(Mana:(wt&x&dose&x&0.1( & ((((*((((10-30(grams/day(weight(gain(
(1-5mck/kg)( & ((((------------------(
1amp&(10ml)&+&200&D5W& & ((((ideal(body(weight(gain:(
& ((((+(((([corrected(body(weight](
Nitroglycerin& 0.25;0.5mcg/k/min&
& ((((------------------(
1mg/mL(10mL)& &
& ((((ideal(body(weight(for(the(day(
5mg/mL&(5,10mL)& 1&amp&+&20cc&D5W&(:330)&or&&
& (
2amps&+&30cc&D5W&
& &
Omeprazole& 1mg/kg&
& &
& (nelson:&0.7;3.3mkday)(
& &
& ( & &
( & &
IMMUNIZATION( & &
OPV(6wks-10wks-14wks( & &
DPT(6wks-10wks-14wks( & &
Hepatitis(B(0-1mos-6mos( & Hematology(
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vaccine& 1st& Interval& Dose& Route& & pRBC=((desired(hct-act.(hct)(x(wt.(
dose& (mL)& & max:&10;15cc/kg&
& ANEMIA:((depends(on(hgb(level:((
BCG& At( ( 0.05( Intra(
SEDATION&SCORING& (hgb(5g/dl(5(cc/kg/alig.((
birth( dermal(
1.Awaken-(voice( (
DPT& 6wks( 4wks( 0.5( IM( 2.Awaken-(voice(+(painful(stimulus(
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3.Profound(sedation-(
drops( Total&bld&vol:&&
(
Hepa&B& At( 6wks( 0.5( IM( Preterm:&90;100cc/kg&
HYPERKALEMIA&
birth( after( Term:&80cc/kg&
1. NaHCO3( IV( bolus( (1-3meq/kg)( x( 5-
( 8( wks( Double&exchange:&&
10min(
after( or( Est.&blood&Vol.&x2&
2. Glucose(+(insulin(
8mos.( Est.&blood&vol&x&wt.&
=((0.1u/kg+d5w(2cc/kg)(
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3. Salbutamol(
( 4. Ca(gluconate((1mkdose(0r( Exchange(transfusion/phlebotomy(
( 100mkdose)( &&&volume&of&exchange&in&ml&=&&
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& (total& bld.& Vol.& x& kg)& x& & (desired;actual&
hct)&÷&actual&hct&
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&
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& & 100mg/5((((((10-20mkdose(PO(
& & 200mg/5((((((5mkdose(IV(
& & 300mg/amp((((
&
& WBC& Hgb& & Cisapride(((((
&
NEONATE& 8-30( 13-20( & & 1mg/ml(((((0.2-0.6mkdose(q8(
2wks& 4-20( 13-20( & & Dicycloverine(10mg/5ml(
2mos& 5-20( 10-15( & & ( ((((((((5mg/5ml( ((
2yr& 5-15( 11-14( & & (((Adult( (((((((((10mg&TID((
& & (((2-12yo( (((((((((10mg&TID/QID&
& (((6mos-2yo((((5;10mg&TID/QID&
ANC& WBC&×&&segmenters&×&1,0000&
Normal&>1,5000& & (((Drops:&&&&&&&6;12&mos&&0.5;1mL&
& & Domperidone((((0.25;0.3mkd&
& & 10mg/5ml(
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&Retic.& &&&&&&&N&hct&for&age& & Famotidine( 0.6;0.8mkD(
&Count( & 20mg/amp&& 1;1.2mkD&
& Retic(Index(>2=(hgge/(hemolysis( & Omeprazole(20mg(
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abn& & Ranitidine(& 5;10mkd&PO&
& & & & 1;3mkd&q8&
Erythropoetin&(75;100mkdose)&& & Sucralfate(500mg( 40;80mkd&q6& & (((&
Blood&products&“u’/kg&&&&&&&&&&&&Rate& & (
pRBC& 10;15cc/kg& 4-6hr( & Antipyretic/NSAIDS&
& Aspirin( ( 60;90mkD&
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&
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1&unit/7&kg& & Ibuprofen((
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&
FFP& 10;20cc/kg& Fast(drip-dec(BP( ((((((200mg/5(
&
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& &&&&50mg/5(&
(>2xl)(
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(12.5gms)( adustment( & &&&10mg/ml( &
& Paracetamol(& 10;15mkd&
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Start(IVF(w/(D5NM(to(run(at(80cc/hr(
1&unit/5kg&
((((soluset)(X(6hrs( &
&&&&&&&&&&&&&&&&&SQ(weekly(x(6& After(6hrs(of(hydration,(start(cyclophos( Anti;tussives/Decongestant&
& Dissolve(1g(of(cyclophosphamide(in(50cc(( Ambroxol((((((((((((1.5;1.6mkd&
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& After(cyclophaosphamide(tx,(inc(( (50/ml( ((((((((((((15;30mkd(
& (((mainline(to((65cc/hrx(4hrs(
& Monitor(bp(q30min(while(ongoing(infusion( Newborn(of(Tuberculous(Mother( &
& Watch(out(for(hypotension,(( Mother& Dx( Patient( Tx(
& ((((dyspnea.vomiting,(Hypersensitivity(rxn(
& ( TB(infxn( BCG( (none(
&
& +PPD(
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& IV&Ig&
2gms/kg___( w/&2wks&(
&&&&&( 10gm/200cc( Current&dse.& TB(dse.( PPD( INH(or(
& 5gm/100cc( w/o&tx( CXR( RIF(
& 2.5gms/50cc( Hema&& TB(dse.( PPD( INH(
& (
spread( spread( CXR( RIF(
Secure_gms(of(IV(Ig(to(transfuse(as(ff:(
! (((Test(dose:(0.5(×!wt=_cc(run(in(30min.( AFB(aspirate( PZA(
! (((Test(dose:(1(×(wt.=_cc(run(in(30(min.( Strep.(
! Watch(out(for(unusualities(in(every(test( 100mg/5ml(
((((dose(like(dyspnea,(vomiting,((
& INH& 200mg/5ml( 10-20mkday(
((((hypotension,(fever((and(other((
& ((((signs(of(hypersensitivity(rxn( RIF& 100-200/5ml( 10mkday((((((>12yo(
& If(no(unusualities(noted(( 10-15mkday(<12yo(
& Give(remaining____(for(12hr(x(cc/hr( PZA& 500/5( 15-30(
& Off(mainline(IV(while(on(IVIg(infusion( 250/5( 25mkday(
& (
& Etham& 200/5( 15-25mkday(
& 400/5(
Antacids/prokinetics/&
&
&&&&antispasmodic& Strep& 1(gm/vial( 20-30mkday(
& Cimetidine(( 250mg/5ml(
 1-2yo( ( (1.5ml( (((((TABLET((((400(mg( Folic(acid(15mkdose&
40mg/5ml(drops)( Aminophylline((5(mkdose((loading(dose)( (((((((((((((((30mkdose&(mx)&
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(((((((((3-6mo( (0.75ml( Amounts(of(strile(water( &&&&&&&&&&SQ(weekly(x(6(
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Bronchofen((TID(or(QID)& & &
(
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&
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1-2yo( ( 1.25ml( 12.5/5ml(:(3;5mkDq6-8& >(2yo( 40mg( 1ml(
6-12mos( 0.75-1ml( Prednisone((1;2mkdq&p&meal& Vitamin(A(
1-6mos( 0.5-0.75ml( Hydroxyzine1(mkd(BID( (<6mos( 50,000iu(
( 10mg(tab(((( 1;2mkd&BID( ((>6mos((100,000iu(
Anti;Kochs& 25mg(tab(OD((((2mkday( ((>1yo(((((200,000iu(
INH&10&mkd& 2mg/ml(susp( Ursofalk((15-40mkdose(
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125mg/5ml(
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250mg(tab(
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<6mos( 1(tsp(BID( 125mg(tab(
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>6mos( 1tsp(TID( Note:((trichurias((x2(days)(
( 7-24(mo(1ml(TID/QID(
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( 1-6(mo(((((.5ml(TID/QID(
10,15,30mg(sachet( &
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(<6mos(10mg& TID/QID(
&
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1mg/ml( 0.25mg/kg(
drops(10mg/mL( Mebendazole&100mg&BID&x3D&
10mg/ml(
& & & &500mg&SD( &
Adult/>12yo((1(tab(OD(
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6-12yo( (((((½(tab(BID(
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2-5yo( ((((1ml(BID,(2ml(OD(
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(
& &&&& >6yo&5ml&BID& ((((((((10(mg/tab(BID((
(
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& &0.03ml/kg&resp.soln& Metronidazole(30;50mkd(q8h(PO( (
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&&&&&&&&&&&&Tablet&2&mg,&4&mg& 200mg/5ml(
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0.01ml/kg/d&–bronchodil( 500mg(tab(
&26.7mg/5ml&&
&80mg/ml((((((&&&&& 0.1ml/kg;q3-4min(IV(for(( 250mg(tab(
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(((((SYR(((((100MG/5ML( 15mg/ml(drops( &
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125mg/5ml(
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500mg(cap(
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&
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Note:(Can(be(given(to(px(w/(( Clarithromycin((
Nicardipine(drip:(
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500mg(tab(
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& &3.2gms/day& (6-12y.o(( 100mg(ped(tab(
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PO(Antibiotics((
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(((((Tablet(150(mg(;(300(mg(
125mg/5ml( (((((Ampule(150(mg/ml(
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((((((((228.5mg/5mL((200(/28.5)( Susp(200mgh/5(ml(
Blue(400(mg( MOTOR(
((((((((457mg/5mL((400/(57(mg)((
Sultamicillin( Pink(800(mg( Follows( 6( Normal( 6(
Sumapen(125/5,250/5( ((((((( commands( spontaneous(
( Chloramphenicol( 50;75mkd(q6h( ( movements(
Cloxacillin(50-100(mkd(q(6(hrs( 125mg/5ml( capsules:( 250( mg( ;( 500(
((((Suspension:(125mg/5;(250/5( mg( Localizes( 5( Withdraws(to( 5(
((((Capsules(250(mg;(500(ml( pain( touch(
Clindamycin((20;40mkD&q6;8h(
( ((((((75mg/5mL( Withdraws(to( 4( Withdraws(to( 4(
& ((((300mg(cap( pain( pain(
Cephalosporins& ((((150mg(cap(
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250mg/5ml( 400/80/5ml( flexion( flexion(
125mg/5ml( 200/40/5ml( Abnormal( 2( Abnormal( 2(
125mg/1.25ml( 800/160(mg(tab( extension( extension(
100mg/ml( 400/80(mg(tab(
250mg(cap( SMX-(400,(200( None( 1( None( 1(
500mg(cap( TMP-80,40( (
Cefdinir((((7mg/kg;4mg/kg& Cotri(prophylaxis:(wtx(1mg/kgx(5/80(
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&&&&&&&&&&&&&&&&&&-q12H/OD( Clindamycin((((10;30mkd((
&
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500mg(cap(
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 &
IV(Antibiotics(((((mkday( TABLE&1;4(--(ACUTE&MANAGEMENT&OF&SEIZURES(
( Time&
Cefamandole&&&&50-150(q6;8h&
Cefazolin&& 50-100&q6h& Imepinem& 15mkdose(q6& (min)& Intervention&
Cefipime& & 100-150-q12&h( Meropenem( 60mkday(q8(((( 0–5( Stabilize(the(patient(
Cefoxitin& & 90-100&(NB)& (((sepsis:&&20&q&8hrs&
( ( ( Assess(airway,(breathing,(circulation,(
& & 80-160( IV(infusion(over(30(minute&&&&
and(vital(signs(
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& &&&&&&100&<&7days&neonate& (((((Pseudomonas(sp)&& ( ( ( Administer(oxygen(
& &(
& & 150(>7days&old& ( ( ( Obtain(intravenous(access(or(
Aztreonam& 90-120(q6;8h(
& & 100-150&q8;&adult& intraosseous(access(
Chloramphenicol&
Cefotaxime& 100&q12&NB&≤&7D& ( Correct(hypoglycemia(if(present((dextrose(
(((((20-25&q24&(≤7days&old&NB)&
& 150(q8&1;4wks&old& 25%(2–4(mL/kg).(adolescents,(give(
&&&&50-100mkdq4;6h&&
(((((((((((((((((((((((((50-180(q4;6;infants& thiamine((100(mg)(first(
&&&&(children/adult)&
((((((((((((((((((((((((((200(q6&(meningitis)& ( ( ( Obtain(laboratory(studies:(Consider(
Clindamycin&5-20mkd/2;3d&(NB)&
( 1-2gms(q6;8& glucose,(electrolytes,(calcium,(magnesium,(
& &&&&&&15-40mkd&q6;8&
&&&&&&&&&&&&max:12gms/day&(adult)& BUN,(creatinine,(and(LFTs,(CBC,(toxicology(
(((((((((((((((((((((25-40mkd&q6h& screen,(anticonvulsant(levels,(blood(culture(
Ceftriaxone& &50-100&q12;&OD&
Ciprofloxacin( 10mkdose(q12& (if(infection(is(suspected)(
Cefuroxime& 20-50&q12&(NB)&
Metronidazole&10-30mkd&q8&or&
50-100&q8;6h& ( ( ( Initial(screening(history(and(physical(
& &&&&&&&&&15-35mkday&q8h& examination(
750mg-1.5gmsd&q8&
OTHER&IV&MEDS&
( 5–15( Begin(pharmacotherapy(
&
Ampicillin& Diphenhydramine&&1;2&mkdose& ( ( Lorazepam((Ativan),(0.05–0.1(mg/kg(
(
Mild:&50-100mkday(IV(q6h( IV,(up(to(4–6(mg(or(
Hydrocortisone&4&mkdose&q&6;8&hrs&
Mod:& 100-200mkday(
Severe:& 200-400mkday& &&&&&&&&&Max&dose&&&200&mg&as&LD& ( ( ( Diazepam((Valium),(0.2–0.5(mg/kg(IV(
Bacampicillin& 25-50mkday( &&&&&&&&&100&mg&as&MD& (0.5(mg/kg(rectally)(up(to(6–10(mg(
( ( 200/5,400,800cap( Nalbuphine&&&&&&.13;.15&mkdose&
( ( ( May(repeat(lorazepam(or(diazepam(5–
Ampi/sulbactam& 100-200mkd&& Phenobarbital&&&&10&mkdose&LD& 10(min(after(initial(dose(
Ampi;Cloxacillin& 50-100mkd&& &&&&&&&&&&&&&&5&mkd&&&MD&q&12&OD&HS&
Co;amoxiclav& 15–35( If(seizure(persists,(load(with:(
Diazepam&&&
0;3&months( 30mg/kg(q12hrs.& &&&&&&&&&&IM/IV&.3&mg/kg&q&8&hr.& ( ( ( Phenytoin(*(15–20(mg/kg(IV(at(rate(
3mos;12yr&&30mg/kg(q(8-6hrs.& &&&&&&&&&&&04;0.2&mkdose& not(to(exceed(1(mg/kg/min(via(central(line(
>&12yrs&&&&&1.2gm(q(8hrs-6hrs&& or(
&&&&&&&&Rectal&dose:&0.5&mkdose&ffd&by&.25&
Oxacillin& & 50-200&q8;6h& &&&&&&&&&&&&&.25&mkdose&in&10&min&PRN& ( ( ( Fosphenytoin(†(15–20(mg(PE/kg(
Pen&G&100& 200ukd(( && IV/IM(at(3(mg(PE/kg/min(via(peripheral(IV(
Phenoxymethyl&PCN&k& live((maximum(150(mg(PE/min).(If(given(
& IM,(may(require(multiple(dosing(sites(or(
Megapen&312/5&
&&Mild:&& 250-450T(‘U’( & ( ( Phenobarbital(15–20(mg/kg(IV(at(rate(
(
(((Mod:&& 500-800( & not(to(exceed(1(mg/kg/min(
(((Severe:&625T-1mil(‘u’(
& If(seizure(persists:(
Penicillin&&&&50T-100T”u”mkd&q6h& 45(
&
Piperacillin& 100-300&q6;12&& ( ( Load(with(phenobarbital(if(phenytoin(
& (
Sulbenicillin& 20-80&q4;6& was(previously(used(
&
Ticarcillin& & 50-300(
& ( ( ( Additional(phenytoin(or(fosphenytoin(
Cloxacillin&50-100mkd&q6&>&1&mos&& 5(mg/kg(over(12(hr(for(goal(serum(level(of(
&
Flucloxacillin& 50-100mkd&q8;6h& 10(mg/L(
&
&
& ( ( ( Additional(phenobarbital(5(
( mg/kg/dose(every(15–30(min((maximum(
&
Amikacin&&10-15&or&7.5mkdose( total(dose(of(30(mg/kg;(be(prepared(to(
&
Gentamicin&&4-8mkd(q12;8h;OD&&&&&&& support(respirations)(
&
&&&&&&&&&&&&&&&&&&(5mkdose)& ( ( Consider(IV(valproate,(especially(for(
& (
Kanamycin&& 30-50mkday( partial(status(epilepticus(
&
Nafcillin& 100-200(
& 60( If(seizure(persists,(‡(consider(pentobarbital,(
Neomycin& 50-100(q6-8h& midazolam,(or(general(anesthesia((
&
Netromycin& 5(q12h&
& (
Tobramycin( 3-7.5(q8;24h(
& (
Vancomycin( 40-60((
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