MultiVitamins:

Ascorbic acid
Drops 100mg/mL:
Syrup: 100mg/ml
<3mos: 0.3ml/day
2-6y/o: 5ml/day
3-12mos: 0.6ml/day
7-12y/o: 10ml/day
1-2y/0: 1.2ml/day

Vit. B complex + hysine + beclizine (Appebon syrup)

2-6y/o: 1-2tsp OD
7-14y/o: 2-4tsp OD

Iron
wtx5/elem Fe
1mkday OD- prophylactic
Hemarate 30/5
3-6mkday BID-therapeutic
Iberet 26.25/5
Zinc RD 10-20mg/day
Incremin 30/5
10mgdrops- infant
Sangobion 12/10
20mg- >2yo
Ferlin 30/15

Folic acid
2.5g/ml
0.2 mkday

Vitamin A

6-11mos: 100,000IU 1 dose

12-71mos: 200,000IU

<2yrs: drops
10mg/ml=1ml

>2yrs: syrup
20mg/5ml= 5ml

Analgesics/Antipyretic
Paracetamol (Q4h)
RD: 10-15mkdose PO
10mkdose IV
15mkdose-BFC
Drops: 100mg/ml
60mg/0.6mk
Syrup: 120mg/5ml
125mg/5ml
350mg/5ml
Tab: 325mg/tab
250mg/tab
500mg/tab
Amp: 150mg/ml
300mg/ml

Mefenamic Acid (q6-8hr)

RD: 5-8 mkdose
Susp: 50mg/5ml
125mg/5ml
Cap: 250mg/500
Aspirin (Q4-6H)
RD: 10-15mg/kg/dose upto
60-80mg/kg/24h
Anti-inflam:60100mg/kg/24hPO
Kawasaki: 80-100mkday
Nimesulide (BID)
RD: 2.5-5mkdose
100mg/tab

Ibuprofen
RD: 5-10 mg/kg/dose
PO Q6-8H
Susp: 100mg/5ml
Forte: 200ng/5ml
Cap: 200mg
Antacids
Ranitidine (Q8h-12h)
RD: 0.75mkose PO
0.8-1mkdose IV
Amp: 25mg/ml, 50mg/5ml
Tab: 150mg/300mg
Cimetidine (Q4-6h)

Famotidine (Q12h/IV-Q8h)
RD: 0.2mkdose
Amp: 25mg/2ml
Tab: 20mg/40
Omeprazole

RD: 10-15mkday
<1y.o: 20mkday
1-12y.o: 20-25mkday
Liquid: 100mg/5ml
Amp: 150mg/ml, 100mg/ml
Tab: 200mg, 400mg
AlMg (Maalox) (Q6h)
2-4 tabs max: 16tabs
*take 30 minutes 1 hr after
meal at bedtime
Susp: 180ml; 355ml
Tab: chewable
Fw/flatulence-Almg+dimeticone
(Maalox plus)
Anti-emetic/ Anti-spasmodic
Metoclopramine
RD: 0.5mkdose PO
0.2mkdose IV
Amp: 10mg/2ml, 5mg/2ml
Syr: 5mg/5ml
Tab: 10mg
Dicycloverine HCL (Q8h)
RD: 2.5-5mg/kg/day
6mos-2y.o: 0.5-1ml
2y.o-5y.o: 2.5-5ml
Drops: 5mg/ml, 15mg/ml
Syr: 2mg/ml, 10mg/ml
Tab: 10mg

1mgkday

Ursofalk
10-15mkday
200/5ml

Nifuroxide (Ercefuryl)
<6mos- 10ml
>6mos- 5ml
Adult: 1cap Q6H
Susp: 220mg/5ml
Cap: 200mg
Hyosciene N-Butyl (Bromide)
Q6-8h
RD: 0.15mkdose
Amp: 20mg/ml
Tab: 10mg

Domperidone (Motilium)Q8h*15
RD: 0.3mkdose
Dyspepsia: Adult: 1tab/2tsp Q8h
Children: 2.5ml Q8h
10mg
N/V: Adult: 2tab/4tsp Q6-8h
Children: 5ml Q6-8h
Dyspepsia
N/V
10kg
2.5ml
5ml
20kg
5ml
10ml
30kg
7.5ml
15ml
Anti-Diarrheals
Paroromycin (Humagel)
RD: 20-30mkday 3-4 dived
dose
150mg/cap, 150 mg/5ml
Racecadotril (Hidrasec)
1 mos onwards
RD: 1.5mg/kg/day Q8h
BW
Hidrasec
Sachet
<9kg
10mg
1 sachet
9-13kg
10mg
1 sachet
13-27kg
30mg
1 sachet
>27kg
30mg
2 sachet
Adult dose: 100mg/cap Q8h

Suspension: 1mg/ml

Tab:

Erceflora Bacillus clausii

>1mos: 1-2 vials/day
2-11y.o: 1-2 vials/day
Adult: 2-3 vials/day
Nifuroxamide (Ercefuryl)
<6mos: 1tsp BID
>mos: 1tsp TID

Antihelminthics
Mebendazole
500mg/tab single dose
100mg/tab or 5ml BIDx3 consecutive days
20mg/ml susp: 5ml BIDx3 consecutive days
50mg/ml susp: 10ml SD
Enterobiasis (100mg or 5mg SDrpt 2 or 4 weeks)
Susp: 20mg/ml, 50mg/ml
Tab: 100mg; 500mg
*deworm @2-4 yrs old
Pyrantel Pamoate
RD: 10-20 mkdose
Susp: 125mg/5ml
Tab: 125mg; 850mg
Albendazole
RD: 75mkday
Susp: 200mg/5ml
Tab: 400mg
Quinolones
Ciprofloxacin - BID
Vial: 100mg/50ml, 200mg/100ml, 400mg/200ml
Amebicide
Metronidazole q6h
RD: 30-50 mkday PO
7.5 mkdose IV
15mkdose loading dose
Vial: 5mg/ml
IV: 500mg/100

Furazolidone
RD: 4-7 mkday
Liquid: 16.7 mg/5ml
Susp: 50mg/ml

Susp: 125mg/5ml
200mg/5ml
Paramomycin
RD: 20-30 mkday
Susp: 150mg/15ml

Antihistamine
Hydroxyzine Hcl (Iterax)
Q12h x 5 days
RD: 1mg/kg/day or wt/4
Syrup: 2mg/ml
Tab: 10mg; 25mg
Amp: 5mg/ml
Chlorphenamine Maleate
Q8h
RD: 0.2mkdose
Amp: 10mg/ml
Vial: 10mg/ml
Syrup: 2mg/5ml
Tab: 4mg
*20kg-1/2 amp IM
>20kg-1amp IM
Cetirizine diHCL-OD-BID
RD: 0.25-0.27 mkdose
Drops: 10mg/ml
2.5mg/ml
Soln: 1mg/ml
Sry: 5mg/5ml

Etofamide (Kitnos)
RD: 15-20mkayX3 days Q12H
Susp: 100mg/5ml
Tab: 200mg; 500mg

Desloratadine (Aerius)
6-11 mos: 2ml
1-5 y.o: 2.5 ml
6-11y.o: 5ml
>/=12y.o: 10ml
Syr: 2.5ml/5ml
Tab: 5mg
Diphenhydramine Hcl
RD: 3-5 mkdose PO
1mkdose IV
Syr: 12.5mg/5ml
Cap: 25mg, 50 mg
IV/IM: 50mg/ml

Levocetirizine
0.125mkdose

Tab: 10mg
Mucolytic
Carbocysteine (Q8-12h)
RD: 30-50 mkday
Drops: 50mg/5ml
Syr: 100mg/5ml
Cap: 500mg
<3mos: 0.25ml
3-5mos: 0.5ml
6-8mos: 0.75ml
9-12mos: 1 ml
5y.o: 5ml
Ambroxol (Q8h)
D: 1.2-1.8 mkday
Liq: 15mg/5ml; 30mg/ml
Soln for inhalation: 15ml/2ml
Amp: 15mg/2ml
Ped drops: 6mg/ml
Tab: 30mg; retard cap 75
Bronchodilators
Salbutamol TID
RD: 0.13-0.15 mkdose
Sry: 2mg/5ml
100mg/5ml
Amp: 1mg/ml
Tab: 2mg
Terbutaline BID TID
1-15y.o: 2.5ml

Erdosteine (Q12h)
RD: 10mkday
10-20kg, 2-6y.o: 2.5ml
21-30kg, 7-12y.o: 5ml
>30kg, >12y.o: 5mlTID/7.5ml
BID
Susp: 115mg/ml; cap: 300mg

Procaterol
>/6: 5ml
</=5y.o: 2.5ml
Bambuterol
6-12y.o: 5mkdose
Oral soln: 1mg/ml
Tab: 10mg

<3y.o: 0.075mkdose
Syr: 1.5mg/5ml
Soln: 2.5mg/5ml
Amp: 0.5mg/ml
Tab: 2.5mg

Cephalosporins
1st generation
Cefalexin Q6h
RD: 30-50 mkday PO
50-100mkday IV
Drops: 100mg/ml
Susp: 125mg/ml
250mg/ml
Cap: 250mg; 500mg
Cefazolin
RD: 50-100mkday IV x
3dose
Vial: 250mg
Inj: 500mg; 1g
2nd generation
Cefaclor Q8h
RD: 20-40mkday
Drops: 50mg/ml
Susp: 125mg/5ml
250mg/5ml

Aminophylline/Theophyline
3-5mkdose
80mg/5ml; 125mg/tab,
175mg/tab

Cefuroxime Q6-8h
RD: 20-40mkday PO;
50-100mkday IV
Cefamandol
RD: 50-100mkday
Cefprozil
RD: 20-4-mkday
Powder: 125mg/5ml;
250mg/5ml
Tab: 250mg; 500mg
Cefotiam
RD: 50-100mkday
Tab: 200mg
Vial: 0.5g; 1 gm
Cefixime Q12h UTI: 8 TF: 20
RD: 3-6mkday PO,
15mkday

Tab: 315mg; 750mg

Cap: 500mg

Drops: 20mg/ml
Susp: 100mg/5ml
Cap: 100mg;200mg
Cefdinir
RD: 9-8mkday
Cap: 100mg

3rd Generation
4th Generation
Cefoperazone
Cefepime OD-BID
RD: 100-150mkday IV
RD: 50-100
Vial: 1.5g
Vial: 500mg; 1g; 2g
Ceftriaxone BID
RD: 50-100mkday
Vial: 500mg; 1 g;
250mg
Ceftazidime
RD: 30-50mkday IV
Vial: 250mg; 500mg;
1g; 2g
Cefpodoxime
3-10mkday
Susp: 50mg/5ml
Tab: 100mg
Co-Amoxiclav: 228.5g/5ml; 457/5ml

Aminoglycosides
Gentamycin OD-BID
5-8mkday
Amikacin OD-BID
RD: 12-15mkday
15mkdose OD
\
Vancomycin

RD: 15mkday

Antihypertensives
Furosemide
RD: 0.5-1mkdose
Amp: 20mg/2ml
Tab: 40mg
Hydralazine
RD: 0.1-0.2mkdose
Amp: 20mg/ml
Tab: 10mg; 15mg; 50mg
Aspirin
75-100mkday
Nifedipine Q4-6h
RD: 10mkdose
Max: 10mg/kg/24h
Spironolactone
1.3-3mkday QID PO

Antifungal
Nystatin Q6h
Adult & children: 4-6ml
Infant: 2ml
Tab: 500,000 U
Susp:100, 000 U/ml

Fluconazole OD
RD: 3-6mkday
Vial: 3mg/ml
Cap: 50, 150, 300mg
Griseofulvin
Tab: 125mg/500mg

Amphothericin B
RD: 0.3-0.7mkday
Slow in Infusion
*250mcg/kg/day1mg/kg/day
Vial: 50mg/5ml; 2mg/ml
Cap: 50mg; 100mg;
200mg

Isoprinosine: 50-100mkday

Macrolides
Erythromycin q8h
RD: 35-50mkday
Granules: 200mg/5ml;
400mg/5ml
Drops: 100mg/2.5ml
Tab: 250-500mg
Clarithromycin Q12h
RD: 7.5mkdose;
15mkdose
Susp: 125mg/5ml
Tab: 250; 500mg
Roxithromycin OD-BID
Adult: 150mg/tab;
300mg/tab Q12h
Children: >40kg
Kiddie tab: 100mg

Ketoconazole x 5 days OD
Adult: 200mg/tab
5-12y.o: 100mg/tab
1-4y.o: 50mg/tab

Azithromycin OD-BID
RD: 15-20mkday
Susp: 200mg/5ml
Tab: 250mg; 500mg
Vial: 500mg
Chloramphenicol q6h
RD: 50-100mkday;
75mkday (enteric fever)
FT infant>/=2week: 2550mg/kg/day
Cotrimoxazole BID
RD: 5-8mkday; 8 UTI; 10 BPN
Susp: 200mg/40mg/5ml(40mg/5ml) (wt/2)
400mg/80mg/5ml(80mg/5ml)(wt/4)

Tab: 400mg/80mg;
800mg/100mg
Anti- TB drugs
1-10; R-15; S-20; E-35; P-30
Isoniazid
Rifampicin:
RD: 5-10
RD: 10-15mkday
Syr: 100mg/5ml;
Drops: 100mg/ml
200mg/5ml
Cap: 300; 45mg
Tab: 100mg; 200mg;
300mg
Pyrazinamide
Ethambutol
RD: 15-30mkday
RD: 12-25mkday
Susp: 250mg/5ml
Syr: 125mg/5ml
Tab: 500mg
Tab: 400mg
Streptomycin
Amantadine HCL
RD: 15-20mg/kg/day
RD: 4.4-8.8mkday
Vial: 1gm
Syr: 50mg/5ml
Tab: 100mg
Ribavirin
RD: 10mkdose
Syr: 50mg/5ml
Tab: 100mg
Anticonvulsants/ Sedatives
Phenobarbital
LD: 10mkday
MD: 5mkdose (max
25mkdose)

Midazolam
RD: 0.2mkdose
Tab: 15mg
Amp: 5mg/ml, 5/5, 15/3

Diazepam
RD: 0.2-0.8 mkdose

Steroids
Prednisone BID
RD: 1mkday BID; 2mkday
OD
Susp: 10mg/5ml
Syr: 5mg/5ml; 20mg/5ml
Tab: 1, 5, 10, 20, 30,
50mg
Hydrocortisone
RD: 5mkdose Q6-8h
LB: 10mkdose
MD: 5(max 100)
Vial inj: 100mg; 250mg;
500mg
Erdosteine (Ectrin/Zertin)
175mg/5ml-10mkday BID;
300mg/cap BID
Combivent: 200ug Ipatropium
<2y.o: 5-8 drops; 2-3 y.o: 3

Phenytoin
LD: 10mkdose
MD: 5mkday
Susp: 30/5, 12/5
Cap: 30, 100

Dexamethasone
RD: 0.5 1mkdose
0.3mkdose initial, then
0.1
mkdose 1-2mg/kg
Q6h x 4
*xtubate on 3rd dose
Procaterol (Meptin) BID-TID
RD: 0.25mkdose or
0.25xwt
Syr: 5meq/ml
Tab: 25meq, 50meq
Aminophylline
LD: 5-7mkdose
MD: 3-5mkdose
drops; >4y.o: 20 drops

IVIG
Dose: 2g/kg in 12H or 400mg/kg/dose x 5d
2.5g/vial, dilute w/ 50ml diluents to make 50mg/ml
administer the ffL

Test
0.1
0.2
0.4
0.8

dose:
NAHCO3
0.5ml/kg/H x 15min
BE x wt x 0.3 or 1meq/kg
1ml/kg/H x 15min
can be given IV push or drip
1.5ml/kg/H x 15min
50mcg/kg NA>1-2 meq/kg
2ml/kg/H x 15min
2.5ml/kg/H x 15min
3ml/kg/H x 15min
3.5ml/kg/H x 15min
4ml/kg/H x 15min
*if tolerated in fuse the rest at ____cc/h for 10hr watch out for
headache, flushing, hypotension, fever and chills
Aminosteril
0.5/kg-inc until 3g/kg
Wt x RD x 100/6%/24 or wt x RD/0.694
*start 1g x 48H then resume at 2g
Conversion of Hyponatremia
1ml=2.5 meqs NaCL
Wt: 1.8 kg
S.Na: 131.4
D-A x wt x 0.6 (140-131.4 x 1.8 x 0.6 = 9.2 meqs)+ wt x 3=
maintenance (1.8 x 3=5.4)
- 4.6 1.8 6.4
- 2.3 1.8 4.1
- 2.3 1.8 4.1
1st Shift
D5W- 6.6
D5IMB- 50

HYPONATREMIA
D-A x wt x 0.6 (2-3) maintenance
HYOPCALCEMIA
K/K (?) 0.1 to 0.3 meqs/k/H
NK of Body= 50meqs
K/R meqs KCL/#Hrs/wt

NaCl- 2.5 (?)

Hypokalemia
D-A x wt x 0.3 + (Wt x 2) ?
Wt x 0.2 x 8 x 3 x 2 x wt
Sk- <3-5% -0.05
<2.5-10%-0.10
Wt X 0.05 x 50 /wt x (2/maintenance)
RESPONSE TO PHOTOTHERAPY
*check rebound B2 for 12-24H after discharge
Bilirubin
<18
</=18
</=14
</=15
Age in hours
24-48H
49-72H
>72H

Age
49-7/2
>72
TSB (mg/dl)
<15
15-<20
<18
18-<24
<20
20-<25

Tx/rec

OPD

PHOTO

Action
Wean to single photo
D/C home
D/C photo
D/C photo
20-<25
25-<30
25-</=30

>/=25
>/=30
>/=30

INTENSIVE
PHOTO

PHOTO/exc
trans

IDEAL BODY WEIGHT

At birth
3kg
3-12mo
Age (mo)+ 9 /2
1-6 yrs
Age (yrs)x 2 + 8
7-12 yrs
[Age (yrs)x 7 5 ]/2

IDEAL BODY WEIGHT GIVEN BIRTH WIEGHT

<6mo
Age (mo) x 600 + BW in gm
6-12 mo
Age (mo)x 500 + BW in gm
Age

</=24d
25-48
49-72
>72

Consider
Photo

Photo

Exchange
transfusion if
extensive
photo

Exchange
transfusion if
intensive
photo

>/=12
(170)

>/=15
(260)

>/=20
(340)

>/=25
(430)

>/=15
(260)
>/=17
(290)

>/=18
(310)
>/=20
(340)

>/=25
(430)
>/=25
(430)

>/=30
(510)
>/=30
(510)

EXPECTED BODY WEIGHT

Term: EBW= (Age in days - 10) x 20 + BW in gm
Preterm: EBW= (Age in days - 14) x 15 + BW in gm

Where 10: # of days to recover over physiologic wt loss

20: g/day gained
CARDIAC OUTPUT
Newborn: 180-240ml/kg/min or 4ml/beat
DOPAMINE DRIP
(200mg/250-800conc) 0.0375/26.6
(400mg/250ml-1600conc) 0.075/13.3
Wt x RD x 60 (0.075)

SHORT CUT: wt x RD
(10mg/kg)
13.3 (800-conc)
Wt x RD
26.6 (1600-conc)

WT X 3(50) X dose
6 (100)
Rate (1cc/hr)
1.6

To check: AD: dose given x Prep/60/wt

Or WT x RD X 140D/ 1600/24
Max: 20
LEVOPHED
4mg/4ml; 2mg/ml
e.g 2ml/ml
2/100 x 1000= 20 conc
(WT x dose x 60)= ml
Conc
To check: ml x conc/60/15= dose
DRIP FORMULA
6 x wt (kg)x mcg/kg/min mgin100ml of D5NSS
MI/H
ISOPROTERENOL/EPINEPHRINE/NOREPINEPHRINE
0.6 x wt (kg) = mgin100ml O
*1ml/H will deliver 0.1 mcg/kg/min
DOPAMINE/ DOBUTAMINE/ AMRINONE/ NITROPRUSSIDE
6 x wt (kg)= mg in 100ml

*0.1 ml/H will deliver 1mcg/kg/min

DOPAMINE/ DOBUTAMINE
6 x wt (kg) = # mg to add to diluents to make 100ml volume
DOBUTAMINE DRIP
2.5 15mcg/kg/min (max: 40mcg/kg/min)
Peak effect: 10-20min
Prep: 12.5 mg /ml x 20ml/vial= 250mg/250ml (vial)
Premix: 1000mcg/ml in 250= 250/250 (1mg/ml)
2000mcg/ml in 250 ml= 500mg/250 (2mg/ml)
Dobu-premix
0.06-1000=250/250
D%W
0.03-2000
Wt x dose x 0.06/0.03

Wt x RD x 60 or wt x RD x 1400/12500 or 6 x wt in kg= ____mg in

2000
100ml(1mcg/kg/min)
Ex: 250mg in D5W 250cc(1mg/ml)
500mg in D5W250cc(2mg/ml)
Mcgtt/min= (Wt x DD)/16.6
ugtts/min=(wt x DD)/33.2
= Wt x DD x 0.06
= Wt x DD X 0.03
*to check: 7.5 actual x 2000/ 60 /wt
actual x conc/60/wt

FUROSEMIDE DRIP
20 mg/2ml
**4ml + 20cc PNSS to run @ 1cc/h
(wt)15 x (dose) 0.1 x 24
36 x 2/20 = 3.6
3.6/4ml = 0.9 or 1cc
Prep: 10mg/ml amp (2m)
Dose: infant and child: 0.05 mg/kg/H (titrate to clinical effect)
Adult: 0.1 mg/kg/H (max: 0.4 mg/kg/H)

Wt(kg)x dose x 24 = mg in 24 ml of NS to make: 1ml/H

= 0.1mg/kg/H
Wt(kg) x dose x 24 x 5= mg in 120ml NS to make
5ml/H=0.1mg/kg/H

*20mg furo + 20cc distilled water to make conc of 1mg/ml

Infusion rate: 0.05 x wt eg: 0.05 x mg x 1 = 4 cc
EPINEPHRINE DRIP
Wt x 0.6 mg = mg added to 100mgD5W
1cc/H = 0.1 ug/kg/min
5cc/H = 0.5 cc/min
ml/H= wt x dose x 60
10cc/H = 1mg/kg/min
conc
0.1mkd/0.1cc/kg/dose
INSULIN DRIP
0.1 1 cc or ml/H
Wt x 0.1 x 24 = # of ml/cc of insulin to be added to NSS to
make 24 ml soln to run for 24H

MIDAZOLAM DRIP
Prep: 5mg/ml amp
Dose: intermittent: 0.05 0.15mg/kg/dose
Continuous: 1-2mcg/kg/dose
6 x wt(kg)x mcg/kg/min = mg in 100ml of D5W/NS
mL/H
Max total dose: 10mg (intermittent); can cause respiratory
depression, hypotension, bradycardia
AMIODARONE DRIP
Prep: 50mg/ml amp
Dose: infant and child: 5mg/kg over 30 min ff by infusion starting
at 5mcg/kg/min
Max dose: 10mcg/kg/min or 20 mg/kg/H must be diluted in D5W
infusion concentration should not exceed 2 mg/ml
wt(kg)x dose x 60 x 50 = mg in 50mlD5W
1000
To make: 1ml/H= 1mcg/kg/min
INSULIN DRIP
Prep: 1U/ml amp
Dose: Infant and Child 0.1Ukg/H (titrate to clinical effect)
Glucose drop: 80-110mg/dl/H
Wt(kg)x dose x 24 = U in 24ml NS
or
Wt (kg)x dose x 24 x 5 = U in 120ml of NS
*to make: 5ml/H= 0.1U/kg/H
NICARDIPINE DRIP
Prep: 2.5mg/ml= 5mg/10ml ampule

Dose: Child: 0.5-5mcg/kg/min (titrate to clinical effect)

Adult: start with 5mg/H, increase dose as needed by
2.5mg/H Q 5 -15 min (Max dose: 15mg/H) decreased by
3mg/H as needed to maintain desired response
AMINOPHYLLINE DRIP
LD: 5mg/kg BW in 30cc 5W in a soluset (if px is not maintained
on oral theophylline) or
25mg/vial dilute 1ml + 4ml NSS to make 5 mg/ml so;ution.
Aspirate ____mL give per iv infusion for 30 min as LD
(5mg/kg)
D5W250cc + Aminophylline 250mg/amp at ____ugtts/min
Main drip: 0.4 0.8mg/kg/H
Formula ugtts/min = dose x BW
Note: maintenance infusion rate must be induced to 0.2 0.3 mg
/kg/H for elderly px, pregnant px and those in CHF. Liver dse or
cor pulmonale watch out for hypoglycemia and tachycardia.
DUET (Double Volume Exchange Transfusion)
Blood volume: 80cc/kg
ABC: no correction if <10
E.g wt: 3kg
B.D
3 x 80 x 74-60/74 = 3360/74
45cc to be exchanged
160-180cc/kg/FWB
Mothers Blood type wt 80 x 2
INDICATIONS:
Corrected WBC:
Sepsis
e.g RBC = 7500= 75000/500-15
S. Bilirubin >20mg/dl
for every RBC = 1 WBC
WBC = 37-15=22 corrected RBC
Hypoxia and acidosis
Hemolytic dose of NB

ABO incompatibility
Prematurity
COMPLICATIONS:
Vascular embolism
Infection
Cardiac arrhythmia vol overdose
CP arrest
Electrolyte imbalance
FIO2: 100% target FiO2 X TRF (S)
79
ABDOMINAL UTZ
Stomach LUQ, directly under the L diaphragm
Small Intestines- central abdomen,
can have a random faceted/ tesseliated appearance
when air filled (but not dilated).
Encircling valvulae connivantes visible depending on
degree of air filling.
Valvulae connivantes more widely spaced in ileum
Large Intestines circumferential, tends to frame the small intestines
Feces of variable consistency
Haustral folds interspaced w/ plicae semilunaris

Neurotoxicity

Cisplatin ototoxocity, p. neuropathy

Paclitaxel p. sensory, neuropathy

Vinca Alkaloids- motor , sensory, autonomic neuropathy,

adynamic ileus, urinary bladder atony
Cardiac Toxicity

Doxorubicin, Daunomycin cardiomyopathy

Pulmonary Toxicity

Bleomycin interstitial

Alkylating agent pneumonistis w pulmonary fibrosis

Gastrointestinal Toxicity

Mathotraxate hepatic fibrosis

Vinca Alkaloids- adynamic ileus, urinary bladder atony

Genitourinary Toxicity

Cisplatin azotemia, Mg wasting

Methotrexate oliguria RF

Cyclophosphamide/ Ifosfamide chronic hemorrhagic

cyctitis
Dermatologic Toxicity

Doxorubicin

Actinomycin D
Vincristine

Skin necrosis, sloughing

from
drug extravasation

Gonadal Dysfunction

Azospermia recovery is uncommon

Hematologic toxicity

Granulocytopenia/neutropenuia
6-12 days after administration
Recovery in 21-24 days
ANC= (WBC count)(%segmenters)
Must be 1500 for chemo to proceed

Thrombocytopenia
Recovers 4-5 days later than granulocytes
100,000/mm3 for chemo to proceed
Fontanels anterior closes at 18 mos (as early as 9=12 mos)
Posterior 6-8 weeks
Colostrum 1st 2-4 days postpartum CHON, vitamins, salt, Ig
fat and sugar
Absolute Contraindications to BF

Galactosemia

Tyrosinemia
Relative Contratindications to BF

Psychosis

Active TB
WATERLOW CLASSIFICATION
> 90
no PEM
75-90
MILD
60-74
MODERATE
<60
SEVERE

WT for Age: Actual WT x 100%

Wt at P50

HT for Age= Actual HT X 100

Ht at P50
Wt for HT = Actual wt X 100
Wt at P50 of HT at P50
HT
>95 - no stunting
90-95 mild
85-89- moderate
<85- severe

WT
>90 no wasting
80-90- mild
70-80- moderate
<70- severe

ET Tube Size
<1000
1000-2000
2000-3000
>3000

Premature
0-3 mo
3-7 mo
7-15 mo
15-24 mo
2-10 yrs
10-20 yrs

AOG
<28
28-34
34-38
>38

SIZE
2.5
3.0
3.5
3.5-4.0

ET SIZE BY AGE
2.5mm
3.0mm
3.5mm
4.0mm
4.5mm
Age (yrs)+16/4 or Age(yrs)+ 4/4
6-8mm

ET level: size of tube x 3

Laryngoscope Blade Size

Term/Newborn
Size 1
2-11 yrs
Size 2
>12yrs
Size 3
ET Tube Size & Depth
Weight
500-1000
1000-1400
1400-1900
1900-2200
2200-2600
2600-3000
3000-3400
3400-3700
3700-4100
4100-4500
>4500

1.

2.

3.

Size
2.5
3.0
3.0
3.5
3.5
3.5
3.5
3.5
4.0
4.0
4.0

Depth
7.0
7.5
8.0
8.5
9.0
9.5
10
10.5
11.0
11.5
12.0

BELL CLINICAL STAGING OF NEC

Suspect,
Infant with suggestive clinical signs but x-ray non
diagnostic
Definitive
Infant w/ pneumatosis intestinalis
2a: mildly ill
2b: moderately ill (acidosis, thrombocytopenia/ ascites)
Advanced
3a: critilac w/ impending perforation
3b: critical w/ proven perforation

MAXIMUM K that can be in cooperated per Liter IVF:

Parenteral: 40meqs

Central: 60-80meqs

I.

II.

Electrolyte Computation:
Potassium

N= 4-5.6 meq

N K deliuence: 0.1-0.4meq/kg
Deficit = (KD - KA)x wt x 0.6
Maintenance K: 2 x wt
Total K deficit: deficit + maintenance
Full Incorporation: 40meq/L or 20 meq/500cc
K infusion rate:
N= 0.2meq 0.4meq/kg
IV rate x amt of K (meq)
Vol of IVF x Wt
Deficit: Wt x 50 x __K__
Maintence 2 x wt
Sodium 135-145 meq
Maintence Na= 3 x Wt
Max target/day: 10 meq

Na: 1 meq= 2.3mg/dl

K= 1 meq= 3.91mg/dl

NaHCO3= gr x = 650mg = 7.7meq

gr v = 325
III.
IV.
V.

Calcium: 8-10 meq

Chloride: 98-106 meq
CO2 15meq
Rate x 24= ___ 100= ____ x 4

Creatinine Clearance:
1.
Based on ht
*0.33 = pretem; lbw, <1 yr
0.45 = term, infant, <1yr
0.55 = children, adolescent female
0.7 = adolescent male
* X ht (cm)
Serum creatinine(mg/dl)
2.

Adult

*male: 72
Female: 85
140-age x wt
* x Creatinine (mg/dl)
Values:
80-120: normal
50-80: renal impairment
20-50: renal insufficiency
5-20: renal failure
<5: uremia

GFR: 125ml/min (75-150)

24 urinary Creatinine M: 15-20mg/k
F: 10-15mg/k
ACTUAL RETICULOCYTE COUNT (ARC)
Actual Hct x Reticulocyte ct
Desired Hct
Reticulocyte Index: ARC 2
= HCT/Ret Count x 2
>2= hemolysis

<2= BM suppression
IDEAL TRACHEAL ASPIRATE: EC < 25
PMNS> 10
1
U- increase HGB by 2: HCT by 3
BLOOD TRANSFUSION
FWB 20cc/k (max)
PRCB 10-15cc/K (15cc/k in neaonates)
FWB: vol= desired-actual HB x 6
= desired actual Hct x
Rate= volume x 12 gtts/ml =
60min x 4H
PRBC: vol = desired actual HB
= desired actual hct
Desired Hct= vol/wt + actual hct

x wt
wt
gtts/min
x 2 x Wt
x wt

Platelet Count: 1U /6KBW

1U=30-50 (raises platelet count by 10K)
FFP= Fluid rate (5-20cc/k/h in 4h)
PHOTOTHERAPY
Indication: PT 10mg% Bilirubin
PT 15mg% Bilirubin
Complication: Osmotic diarrhea, Rashes
Bronze baby syndrome, Dehydration

Kramers Classification
ZONE
JAUNDICE
1
Head/neck
2
Upper trunk
3
Lower trunk to thigh
4
Arms/legs/elbow/knees
5
Hands/feet
B1 uncongugated/ indirect
B2 conjugated/ direct Bilirubin

EST. LEVELS
6-8mg/dl
9-10mg/dl
12-14mh/dl
15-18mg/dl
>18mg/dl

CREATININE CLEARANCE*
(140-age) (wt in kg) x 0.85 (F) 1(m)
Creatinine (mg/dl) x 72
* 88.4 mg/dl
STAGING
1
2

Kidney damage with NGFR

Mild GFK

>90
60-90

3
4
5

Moderate GFK
Severe GFK
Kidnet failure

30-59
15-24
<15

DEFICITS
Na= 135-150/3-4meq/kg/day
Na deficit= (Desired 140-actual) X TBW
TBW (L)= 0.6 x BW (kg) + Maintenance
BLOOD/ FFP TRANSFUSION
Transfuse ____ U ( cc)TS x 4h

Monitor VS q15mins @ 1st hr then Q 30min

Adjust IV rate to ___ cc/hr
Ex: 369cc/4h = 92.25 92
IVF = 125 = 33
92
* IVF rate to 33cc/hr
How: 125-92=33cc/hr
RBS (mmol/L) x 18 = ____ mg/dl
N: 280-300
DKA: 300-320
HHS: 330-380
FFP- 20cc/k
PLT conc- 1 uint/10kg
TPR
BP
02 stat
SCE, CBS
(-)DOB
CP status assessed, may transfuse 1 unit PRBC, type-specific, after
proper reverse typing x 4hrs. Monitor VS q 15mins on the 1st hr
then q30mins thereafter once stable IVF rate to ___ cc/hr (or
KVO) watch out for any BT reactions
Refer PRN
Thank you
PPE: awake, conscious, not in CPD, anicteric sclera, pinkish
conjunctivae, non hyperemic, non-enlarged tonsils, (-) CLAD, ()NVE
SCE, CBS
AP, NCRRR (-)murmur

Flat, soft, NABS, Nontender, tympanitic, grossly N

CRT < 2 sec.

ext, full pulses

TRANS-OUT ORDERS (SURGERY/OB)

May transfer px back to room
Monitor VS q15 until stable then q4h thereafter
D/c o2 and pulse oximeter
Monitor IO qhourly (if with FC)
Refer if with UO 30cc/hr or monitor IO qshift & record
Refer PRN
Thank you
Albumin Transfusion
Wt x 1cc x 50% = amount in CC
Kg
12.5
KAWASAKI DSE
Fever= 5 days
1.
Bilateral bulbar conjunctival injection with limbic sparing
(-)exudates
2.
Erythematous mouth and pharynx, strawberry tongue, red,
cracked lips
3.
Polymorphous, generalized erythematous rash
4.
Changes in peripheral extremities consisting of induration
of hands and feet
5.
Acute nonsuppurative cervical lymphadenopathy
(uni/bilateral) ~1.5 cm

IVF: D10 1st24hrs of life

D10IMB after 24 hrs of life
How to replace fluids: 1st 24HDL wt x 80cc/kg if NPO
Day 1
90 cc/kg
2
100 cc/kg
3
110 cc/kg
4
5
6
7
8

120 cc/kg
130 cc/kg
140 cc/kg
150 cc/kg
160 cc/kg (max)

D10IMB = Desired Actual x volume

Highest Lowest
Available: D5IMB; D50W, D10W
D10IMB=
10-5 x volume (100)
50-5
= 5 x 100
45
11ccD50W 11 D50W (subtract from the volume 100)
+ 89ccD5IMB 89 D5IMB
D10IMB
UMBILICAL CATHETERIZATION
Wt x 3 + 9 = answer + 1.2 cm
2

Allowable Blood loss in Preterm: 10% of BW

Allowable Blood loss in infants/neonates: 20% of BW

H. Influenzae: 7-10days
S. pneumonia: 10-14 days
N. meningitides: 7 days
E. coli, citrobacter, Senatia: 21 days
Enterococcus: 14 days
MENINGITIS

<1mo: GBS, enterobacteriaceae, listeria, monocytogenes

Tx: Ampicilin & Cefotaxime
Alt: Ampicilin & gentamycin
(nosocomial- Ampi + gentamycin)

1mo-3mo: GBS, S. Pneumoniae, Hi. Influenza, N.

meningitides, Enterobacteriaceae
Tx: Ampiciliin, Cefotaxine

>3mo & children S. Pneumoniae, N. meningitides, H.

influenza, neonatal pathogens
Tx: Cefotaxime/Ceftiaxone, Vancomycin added for
possible penicillin resistant S. Pneumoniae

AMINOSTERIL COMPUTATION
Wt x 1gm x 100 = ___ cc to run for 22hrs, rest for 4hrs
6
EX. Wt: 900gms 0.9x 1gm x 100 = 15cc
6
1.
Order: Aminosteril 6% 15cc to run for 22 hrs; rest for 4 hrs
x 2 cycles
(TFI 150- 1gm AA - FFP)
ex: FFP x 2 units 18cc/unit

150-15cc-15cc-18cc+18cc x wt = 84 24 = 3-4cc/hr IVF rate

24H
PIP 8 10 (Pacterm 12)
PEEP 4
100-FIO2 79 x PEEP = level of compressed air
PEEP compressed air level of pure air
RESPIRATORY DISTRESS SYNDROME
Deficiency of pulmonary surfactant, a phospholipid protein
mixture that decreases surface tension & prevent alveolar
collapse.
Type II alveolar cells from 32 weeks AOG
Risk of RDS is decreased in babies born >24hrs and <7days
after maternal steroid administration
APNEA respiratory pause >20sec or a shorter pause assoc. w/
cyanosis, pallor, hypotonia or bradycardia
Causes: Thermal instability, prematurity, infection (NEC, meningitis,
neo sepsis), metabolic disorders, CNS problems (Seizures,
malformations), drugs (maternal/fetal), decreased O2 delivery
(anemia, hypoxemia, L to R shunt)
Disturbance

Primary
Change

PH

Acute resp.
Acidosis

PaCO2

pH

Acute Resp.
Alkalosis

PaCO2

pH

Compensatory Response
HCO3 by 1 meq/l for
each 10mmhg rise in
PaCO2
HCO3 by 1-3meq/L for
each 10mmhg fall in
PaCO2

Chronic Resp.
Acidosis

PaCO2

Chronic Resp.
Alkalosis

PaCO2

Metabolic
Acidosis
Metabolic
Alkalosis

HCO3
HCO3

HCO3 by 4meq/L for

pH each
10mmhg rise in PaCO2
HCO3 by 2-5meq/L for
pH
each 10mmhg fall in
PaCO2
PaCO2 by 1 1.5 x
pH
fall in HCO3
PaCO2 by 0.25 1 x
pH
rise in HCO3

EPINEPHRINE : 1:10, 000 (0.1mg/ml)

Recommended IV does: 0.1-0.3 mg/kg of 1:10, 000 soln via
umbilical vein
0.5 1mg/kg via ET
FFP 4cc/k/ APTT by 1gm/dL

CEFEPIME

Term and preterm infants greater than 28 days of age:

50mg/kg per dose every 12 hrs

Term and preterm infants 28 days of age and younger: 30

mg/kg per dose every 12 hrs

Meningitis and severe infections due to Pseudomonas

aeruginosa or Enterobacter spp: 50mg/kg per dose every 12
hrs

Administer via IV infusion by syringe pump over 30 minutes or

IM.

To reduce pain at IM injection site, cefepime may be mixed

with 1% Lidocaine without epinephrine

CEFOTAXIME
50 mg/kg dose IV infusion on syringe pump over 30 minutes, or
IM.
Dosing Interval Chart
PMA (Weeks)
PostNatal (day)
Interval (hours)
29
0 to 28
12
> 28
8
30 to 36
0 to 14
12
> 14
8
37 to 44
0 to 7
12
> 7
8
45
All
6
Disseminated Gonococcal Infections: 25 mg/kg per dose IV over 30
minutes or IM every 12 hrs for 7 days with a duration of 10 to 14
days if meningitis is documented.
CEFTAZIDIME

30 mg/kg per dose IV infusion by syringe pump over 30

minutes or IM.

To reduce pain at IM injection site, Cfetazidime may be mixed

with 1% Lidocaine without epinephrine.
Dosing Interval Chart
PMA (Weeks)
PostNatal (day)
Interval (hours)
29
0 to 28
12
> 28
8
30 to 36
0 to 14
12
> 14
8
37 to 44
0 to 7
12
> 7
8
45
All
6

RANITIDINE
Oral: 2mg/kg per dose every 8 hrs.
IV: Term: 1.5 mg/kg per dose every 8 hours slow push
Preterm: 0.5 mg/kg per dose every 12 hours slow push
Continuous IV infusion: 0.0625 mg/kg per hour; dose range. 0.04
to 0.1 mg/kg per hour
FLUCONAZOLE

Invasive Candidiasis: 12 to 25 mg/kg loading dose, then 6 to

12 mg/kg per dose IV infusion by syringe pump over 30
minutes or orally.

Consider the higher doses for treating severe infections or

Candida strains with higher MICs (4 to 8 mcg/ml). Extended
dosing intervals should be considered for neonates with renal
insufficiency (serum Creatinine greater than 1.3 mg/dl)

NOTE: the higher doses are based on recent pharmacokinetics

data but have not been prospectively tested for efficiency or
safety

Prophylaxis: 3 mg/kg per dose via IV infusion twice weekly or

orally. A dose of 6 mg/kg twice weekly may be considered if
Candida strains with higher MICs (4 to 8mcg/ml). Consider
prophylaxis only in VLBW infants at high risk for invasive
fungal disease.

Thrush: 6mg/kg on day 1 then 3mg/kg per dose every 24

hrs orally.
INVASIVE CANDIDIASIS DOSING INTERVAL CHART
Gestational age
Post Natal (Days)
Interval (hours)
(weeks)
29
0 to 4
48
>14
24

30 and Older

0 to 7
>7

48
24

OXACILLIN
Usual Dosage: ____mg/kg per dose IV over at least 10 minutes
Meningitis: 50 mg/kg per dose

PMA (Weeks)
29
30 to 36
37 to 44
45

DOSING INTERVAL CHART

PostNatal (day)
0 to 28
> 28
0 to 14
> 14
0 to 7
> 7
All

Interval (hours)
12
8
12
8
12
8
6

MEROPENEM
Sepsis: 20mg/kg per dose IV
Less than 32 weeks GA: less than or equal to 14 days PNA,
every 12 hrs, greater than 14 days PNA, every 8 hrs
32 weeks and older GA: less than or equal to 7 days PNA, every
12 hours; greater than 7 days PNA, every 8 hours
Meningitis and infections caused by Pseudomonas species, all ages:
40mg/kg per dose every 8 hours.

Give an IV infusion over 30 minutes, longer infusion times

(up to 4 hrs) may be associated with improved therapeutic
efficacy.

METRONIDAZOLE
Loading dose: 15mg/kg orally or IV infusion by syringe punp over
60 minutes
Maintainance dose: 7.5 mg/kg per dose orally or IV infusion over
60 minutes. Begin one dosing interval after dose.

PMA (Weeks)
29
30 to 36
37 to 44
45

DOSING INTERVAL CHART

PostNatal (day)
0 to 28
> 28
0 to 14
> 14
0 to 7
> 7
All

Interval (hours)
12
8
12
8
12
8
6

COMPOSITION OF AVAILABLE PARENTERAL FLUIDS

IV
Na
Cl
K
Mg
Ca
HCO3
0.9NSS
154
154
0.3NSS
51
51
LR
NR
NM
IMB

130
140
40
25

109
98
40
22

4
5
13
20

1.5
1.5
1.5

1.5
1.5
-

Serum Anion Gap (AG)= Na (Cl + HCO3)

Urine Anion Gap= (Na + K) Cl
Delta Gap= Actual AG 10
24-Actual HCO3
How to Adjust IVF rate once on Feeding

Lactate
Acetate/Gluconate
Acetate
Acetate

Example: IVF: D5IMB (90)

WT: 2840gms
Computations: 90 x 2.84kg 24H = 10-11cc/hr IVF rate

Advance feeding to 10ccq 3 hrs x 3 feedings

If tolerated, increase to 20cc every feeding until 30cc is
reached.

Adjust IVF rate accordingly

to 8cc/hr at 10cc feeding
to 6cc/hr at 15cc feeding
to 5cc/hr at 20cc feeding
to 1cc/hr at 30cc feeding
10
15
20
30

x
x
x
x

8
8
8
8

24 = 3 [IVF 3 = 8]
24 = 5 [IVF 5 = 6]
24 = 6 [IVF 6 = 5]
24 = 10 [IVF 10 = 1]
feeding q3H 24h 3h = 8
DC CBG monitoring once 20cc feeding is tolerated.

BICARBONATE CORRECTION
(15 initial HCO3) x Vol x Kg BW
Serum HCO3 level (meq/L)
>10
5-10
<5
TOTAL PROTEIN SPILLAGE (TPS)
TPS= Total Protein (mg)
BSA (m2) x 24H

Volume of Distribution (Vol)

0.5
0.75
1.0

FLUID LIMITATION
Volume in 24H = 400-500ml x BSA + Urine output in 24H
Length: inches to cm, multiply by 2.54
Weight: lbs to kg, divide by 2.2
EPINEPHRINE DRIP:
6 X Wt in Kg x mcg/K/min = ____mg in 100ml of D5W/NS
mL/Hr

Set your own rate: ex: 4ml/hr

6 x wt x 0.1 mcg/kg/min
4ml/h
If wt is 40 kg: 6 x 40 x 0.1 = 6mg in 100ml D5W
4
Order: Start epinephrine drip: 6mg epinephrine + 100cc D5w
x 4cc/Hr (0.1 mcg/k/min)
BEVV
BEVV x 0.6 x Wt
(1/2 push then to run for _____) or
Desired actual x 0.3 x wt

DRUGS

RD

Ambroxol

1.2 1.6 mkdose(BIDTID)

Amikacin
(Amikin,
Amikacide,
Onikin)

10mkdose (LD)
15mkdose (MD)
15mg/kg/day (BID)

Amp/Vial:
50mg/mlx2ml
250mg/mlx2ml

Amoxicillin
(Pediamox)

30-50 mkday (TID)

Cap: 250mg;
500mg
Syr: 250mg/5ml,
Ped drops:
125mg/1.25ml,
100mg/ml
Vial: 500mg

Amphotericin B

50-100mkday (IV), 3050mkday (PO),

1mg/kgBW (alternate
day)

Vial: 50mg/10ml

Ampicillin
(Ampicin,
Pensyn)

50-100mkday (IV), 3050mkday (PO),

1mg/kgBW (alternate
day)

Antamin

0.2-0.3mkdose

PREPARATION
Tab: 30mg, Syr:
15mg/ml
Drops: 6mg/ml

Cap: 250mg;
500mg
Syr: 125mg/5ml,
Forte Syr:
250mg/5ml,
Ped Drops:
125mg/1.25ml,
100mg/ml
Vial: 500mg
Tab: 4mg,
Amp: 5mg/ml

Augmentin

20-40mkday (BID-TID)

ASA

75-100mkday (TID)

Aztreonam

30-50mkday
3-5mdose (PO TIDQID)
1mkdose (IV OD)
0.01mkdose q6h
0.02-1.5mkday

Benadryl
Buscopan
Carbocisteine

10-20mkday(infant)
(TID-QID)

Caterizine

0.25mkday

Cefaclor

20-40mkday (TID)

Cefadroxil

25-50mkday (TID)

Vial: 5mg/mlx10ml
Syr: 2mg/5ml
Tab: 375mg;
625mg
Susp: 156.25/5ml;
228.5/5ml;
312.5mg/5ml;
457mg/5ml, IV
Vial: 300mg;
600mg
Tab: 1g
Tab: 250mg.
500mg
Enema: 4mg
Susp: 250mg
Cap: 25mg, 50mg
Syr: 12.5mg/5ml
Inj: 50mg/ml
Tab: 10mg
Amp: 20mg
Cap: 500mg,
Syr: 100mg/5ml
Susp: 250mg/ml
Cap: 250mg,
500mg
Susp: 125mg/5ml,
250mg/5ml
Cap: 500mg

Syr: 125mg/5ml
Cefetamet
Cefotaxime
Cefepime
Ceftazidime
Cefazolin

20mkday (BID)
50-100mkday (BID)
50mkday q 8h
50-100mkday
50-100mkday

Ceftriaxone

50-100mkday (TIDQID)

Cefuroxime

50-100mkday (IV); 2040mkday(oral)

Cefalexin

30-50mkday (PO),
50-100mkday (IV)

Chloramphenicol

50-100mkday

Cimetidine

50-100mkday

Vial: 1g
Vial: 500mg; 2g
Vial: 500mg; 1g
Vial: 500mg; 1g
Vial: 250mg,
500mg, 1mg plus
10ml diluent
Tab:
500mg/500mg
Susp: 125mg/5ml,
250mg/5ml
Vial: 250mg,
750mg,
1.5g
Cap: 250mg,
500mg
Susp: 125mg/5ml
Drpos: 100mg/ml
Cap: 250mg,
500mg
Susp: 125mg/5ml
Vial: 1g
Cap: 250mg,
400mg
Syr: 100mg/5ml
Amp: 200mg/2ml,
300mg/2ml

Ciprofloxacin
(Klaricid)

7.5mkday (BID)

Cloxacillin
(Pharex)

50-100mkday (BID)

Cotrimoxazole

8-12mkday (BID)

Diazepam

0.2mkdose

Diflucan

6-13mkday

Diloxanide

20mkday (TID)

Doxycyxline

204mkday

Erythromycin

30-50mkday

Ethambutol

15mkday

Ferrous Sulfate

1mkday (MRD)4-6mkday
(Txc)

Tab: 250mg,
500mg
Susp: 125mg/5ml
Cap: 250mg,
500mg
Oral soln powder:
125mg/5ml
Tab:
400mg/80mg;
800mg/180mg
Susp:
200mg/40mg/5ml
Tab: 2mg, 5mg
Amp: 10mg/ 2ml
Cap: 50mg;
150mg; 250mg
Vial: 2mg/ml
Tab: 500mg
Susp: 125mg/5ml
Cap: 100mg
Cap: 250mg;
500mg
Susp: 200mg/5ml;
400mg/5ml
Drpos:
100mg/2.5ml
Tab: 400mg;
200mg
Cap: 250mg
Syr: 220mg/5ml

Drops: 75mg/0.6ml
Fluconazole

LD:12-20mkday
MD: 6-12mkday

Furazolindone

4-7mkday

Furosemide

0.5-1mkdose

Gentamycin

5-8mkday

Hydralazine

0.15mkdose (IV)

Hydrocortisone

5mkdose

Hyoscine

0.01mkdose; 0.020.15mkday

Ibuprofen

5-10mkdose

INH

5-10mkday (Premeal)

Isoprinosine

50mkday

Meclizine

12.5-50mkday

Mefenamic Acid

6.5mkdose (Q6h)

Meperidine
Metoclopramide

6mkday; 0.5mkdose
0.25mkdose (IV, IM)

Tab: 100mg
Amp: 50mg/5ml
Tab: 20mg, 40mg
Amp: 10mg/ml
Vial: 40mg/ml;
80mg/2ml
Tab: 25mg
Amp: 20mg/2ml
Vial: 259mg Amp:
100mg, 250mg,
500mg
Tab: 100mg;
Amp:20mg
Tab: 200mg;
400mg; 600mg
Syr: 100mg/5ml
Tab: 300mg
Syr: 100ml/5ml
Tab: 500mg
Syr: 250mg/5ml
Cap: 250mg,
500mg
Susp: 50mg/5ml
Syr: 5mg/5ml

1mkday(PO)

Metronidazole

30-50mkday TID

Nafcillin
Nalbuphine

50-100mkday TID
0.1-0.2mkdose

Nifedipine

0.25mkdose (IV, IM)

1mkday (OP)

Nystatin

400,000U/day NB 1.2M
U/day

Ofloxacin

20-30mkday

Paracetamol

5-25mkdose q4h

Penicillin G
(Penadur)

50-100,00U/mkday,
200,000400,000U/mkday
(meningitic dose)

Amp: 5mg/ml,
10mg/ml

Tab: 250mg,
500mg
Susp: 125mg/5ml
Inj: 500mg
Infusion:
500mg/100ml
Vial: 5mg/ml
10mg/ml
Tab: 5mg, 10mg,
20mg, 30mg,
60mg
Oint: 5g
Tab:200mg,
400mg IV Soln:
200mg/100ml
Tab: 500mg
Susp: 120mg/5ml,
250mg/5ml
Drops: 100mg/ml
1.2M U

Phenobarbital
Phenoxymethylpe
nicillin K
Piperacillin
(Tazocin)

10mkdose (LD) 5nkdose

(MD)

Tab: 15mg, 30mg,

60mg, 90mg
Amp: 130mg/ml

Adult: 250-500mg QID

Child: 50mkd QID
100-300mkday

Prednisone
(Oracort,
Orasone, Prolix)

1-2mkday

Pyrazinamide

15-30mkday

Ranitidine

1-2mkdose BID q8-12h

Rifampicin

10-15mkday (premeal)

Salbutamol
(Ventolin,
Asmalin,
Combivent)

0.15mkdose TID-QID

Spironolactone

1-3mkday

Streptomycin
Sucralfate

20-40mkday
1g/dose QID

Vial: 2.25, 4.5g

Tab: 5mg, 10mg,
20mg
Susp: 10mg/5ml
Tab: 500mg
Susp: 500mg/5ml,
250mg/5ml
Tab: 150mg,
300mg
Amp: 25mg/ml;
50mg/2ml
Cap: 300mg;
450mg; 600mg
Susp: 200mg/5ml
Tab: 2mg
Syr: 2mg/5ml
MDI: 100mcg/dose
Nebule:
2.5mg/5ml,
5mg/ml
Tab: 25mg, 50mg,
100mg
Vial: 1g

(Iselpin)
Tab: 1g
Terbutalin
(Bricanyl,
Terbulin,
pulmoxcel)
Tetracycline

0.075mkdose BID-TID
20-50mkday QID

Theopylline

20mkday q6h

Tab: 2.5mg, 5mg

Syr: 1.5mg/5ml
Neb: 5mg/2ml
Cap: 250mg
Tab: 125mg
SR tab: 250mg
Syr: 80mg/15

DOPAMINE
Wt x ug/min 26.6
Ex: 40kg x 15ug/min or 10ug/min 26
DOBUTAMINE
Wt x ug/min 16.6
DOPAMINE DRIP
(5-8mg/k/min)

100cc

25cc

6 x wt x dose = 21mg of Dopamine

Rate___
1.6
79cc D5W + 21mg of Dopamine
1.5 x wt x dose = 5mg of Dopamine
Rate___
1.6
5mg of Dopamine in 20cc D5W

HEMODIALYSIS PRESCRIPTION
Blood Flow Rate: 5ml/kg/min
Dialyzer:
F4: BSA 0.7
F5: BSA 1.0
F6: BSA 1.3
NSS Flushing 100ml q 15min or Heparin LD: 10-20IU/kg
MD: 10-20IU/kg
Ultrafiltrate 0.2ml/kg/min x ____ hrs
Duration: initial 1.5 2 hrs
2nd day: 3hrs
3rd day: maintemance 4hrs
Bicarbonate bath: prime solution with NSS 120ml

Weigh pt pre & post HD and record

Monitor VS q15mins while on HD
Watch out for Headache, nausea, disorientation, hypotension,
seizure, muscle cramps & vomiting
Labs: pre & post HD
Intradialytic transfusion (if any )
Initial HD: Mannitol 0.5-1.0g/kg to decrease disequilibrium
syndrome in pt w/ elevated BUN (>35mmol/L)
Refer accordingly.
MGH orders for KD
Repeat CBC, Plt, ESR, after 2 weeks
Repeat 2D echo after 6 weeks
Home meds: ASA 80mg/tab 1 tab OD x 6 weeks take on
full stomach

No live attenuated vaccine for at least 11 months

KAWASAKI DISEASE

Febrile, examthematous, multisystem vasculitis

Fever for at least 4 days

+ clinical features (at least 4/5)
1.
Bilateral bulbar conjuctival injection w/o exudates w/
lumbar sparing
2.
Erythematous mouth & pharynx, strawberry tongue and
red, cracked lips
3.
Polymorphous, generalized erythematous rash
(morbilliform, maculopaular or scarlatiniform )
4.
Changes in peripheral extremities (induration of hands
and feet w/ erythematous palm & soles later
w/periungual desquamation)
5.
Acute, nonsuppurative, unilateral cervical lymphadenopathy
at least 1.5cm in diameter or if w/ coronary actery
aneurysims
ATYPICAL KD common in <12 mo old

Coronary artery ectasia/dilatation: confirms diagnosis (14 wks DOI)

Labs: CRP > 3.0mg/dl

1 st 2 weeks of illness
ESR > 40mm/h
PLT ct >450 on days 10-12 of illness
without aspirin & IVIg, fever can last upto 2 weeks or
longer. After fevr resolves, pt can remain notablefor 2-3
weeks. Desquamation of groin, finger, toes after 2-3
weeks may occur.

Labs normalizes w/in 6-8 weeks

Treatment

IVIg high dose

within 10 days

Aspirin

IVIg: 2g/kg as single dose over 10-12hrs

Aspirin: 80-100mg/kg/day x 4 doses

After fever is controlled, Aspirin to 3-5 mg/kg/day,

discontinue after 6-8 weeks if no heart problems
Recommended Dosage and Drip Rate for Kawasaki Patient
Dosage: 2g/kg/12hrs
EX: Pt: 10kg
Patient total needs: 20g of Immunorel
Total Volume need: 400ml to be divide by 12 hrs = 33.33ml
Initial Test drip: 33.33ml/4= 8.33ml for 1st hour
Succeeding Drip Rate
2nd hour: 8.33ml x 16.67ml
Total Volume left: 375ml/10hrs=37.5ml/hr
* Courtesy of Dr. Ana Marie Morelos, Dr. James Angtuaco and Dr.
Edison Ty
GUIDELINES FOR PEDIATRIC PLATELET TRANSFUSION
Children/Adolescents
<50 x 109/L and bleeding
<50 x 109/L and invasive procedure
<20 x 109/L and bone marrow failure with age risk factor
<10 x 109/L and bone marrow failure w/o age risk factor
Infants within the 1st 4mos of life
<100 x 109/L and bleeding
<50 x 109/L and invasive procedure
<20 x 109/L and clinically stable

<100 x 109/L and clinically unstable

WHO GRADING OF DHF
I.
Hemocencentration, fever, & constitutional sx; + TT
II.
Spontaneous bleeding + grade 1
III.
Circulatiry failure, pulse pressure <20mmhg
SBP normal
DSS
IV.
Profound shock, hypotension/unrecordable BP
NORMAL HEMATOCRIT VALUES FOR AGE
Age
Range (%)
2 weeks
42-66
3 months
31-41
6 months 6 yrs
33-42
7 yrs 12 yrs
34-40
Adult:
Male
42-52
Female
37-47

Mean (%)
50
36
37
38
47
42

Source: Nelson textbook of Pediatrics, 15th edition p. 1379

WHO CASE DEFINITION OF DHF (WHO 1975, 1986)
All of the ff criteria nust be present:
1.
Fever (high and continuous of 2-7 days duration)
2.
Hemorrhagic diathesis (at least a positive tourniquest test
except in shock)
3.
Thrombocytopenia (less than 100,000/mm3)
4.
Hemoconcentration (20% or more relative to baseline or
evidence of increased capillary permeability) or evidence
of plasma leakage (i.e. pleural effusion, ascites and/or
hypoproteinemia)

OTHER CLINICAL MANIFESTATIONS SUGGESTIVE OF DHF ARE:

1.
Hepatomegaly (which may be tender)
2.
Circulatory disturbances (restlessness, cool extremities),
capillary refill time >2 sec., tachycardia)
3.
A fall in hematocrit following volume relacememnt
~ These along with a platelet count below 100,000/mm3 can
justify notification of the case as DHF
~ Hematoconcentration may be absent during earlt fluid
replcemnt or in cases where bleeding has occurred.
Unstable VS, urine output
Signs of shock

Immediate rapid volume replacement 10-20ml/kg (or rapid bolus)normal saline or LR

solution

Improvement

Adjust IVT

O2 to Correct Acidosis

SCABIES

Hematocrit

Hematocrit

Blood transfusion 10ml/kg

No Improvement

Colloid infusion 10-20 ml/kg IV

Plasma/Hemaccel / 5% Albumin/
Dextran 40

~ Treatment for dengue shock syndrome grades 3 and 4

Crotamion (Eurax)lotion apply from neck down x 24h then

rinse
DOPAMINE DRIP
200mg in D5W 200cc
mcgtt/mins = wt x DD/13.3
= wt x DD x 0.75
400mg in D5W 250cc
mgtt/min = wt x DD/26.6
= wt x DD x 0.375
6 x wt in kg = ___ mg in 100ml (1ml/hr = 1mcg/k/min)
CRANIAL NERVE EXAMINATION LIST
Rapport with patient
Sit on edge of bed
General inspection

1. Ask for change in

smell
2. Test visual acquity
Test visual fields

Introductions
Diagnostic facies IVC
NGT
IDC
Facial asymmetry
Pupil symmetry
Scars Ptosis eye patch
eye glasses Hearing aide

Snellen chart Left eye

Right eye
Hat pin Left eye Right
eye

Test light reflexes

Test accommodation
Fundoscopy
3, 4, 6. Test ocular
movements ; ask if
diplopia occur

5. Trigeminal Sensory
& Motor

7. Test Facial Muscles

8. Test Hearing and

Balance

Direct Consensual
Swinging torch
Hat pin
Optic disc Retinopathy
Dysconjugate gaze (MLF)
H pattern testing Diplopia
Nystagmus Vertical
Horizontal
Test Intorsion (if CN3
palsy)
Pin prick testing V1 V2
V3
Light touch testing Corneal
reflex
Clench teeth & palpation of
masseter muscle
Open jaw & ptyerygoid
resistance
Jaw jerk
Forehead wrinkling Eye
closure
Blowing of cheeks Smiling
Ear Mastoid Parotid
Palate
Inspection of ear and
tympanum
whisper High tone 68
Low tone 100 Rinnes R
L

Webers
(256Hz)

Nystagmus

 Hallpikes +/- Epleys

Dysphonia Swallowing
Coughing Uvual deviation
Gag reflex
Trapezius mm: Shoulder
shrug
SCM mm: Head turning

9, 10. Deviation to
Normal side
11. test shoulder &
neck movements
12. Tongue Protrusion;
deviation to affected
side
Ask for BSL
If relevant assess other
neurological system
Summary &
interpretation
HEART RATE
NB- 3MOS
3MOS-2YRS
2YRS-10 YRS
>10YRS

Wasting Fasiculation
Dysarthria

Peripheral nervous system

Cerebellar system

85-205
100-190
60-140
60-100

6MOS-12MOS
1 YR-6YRS
7YRS-12YRS

WEIGHT
AGE in mos + 9 2
Yrs x 2 + 8
Yrs x 7 - 5

Ht in cm
Ht in inches

HEIGHT
AGE in yrs x 5 + 80
AGE in yrs x 2 + 32

MEAN
140
130
80
75

Light index
D2 diameter of collapsed lung
DH diameter of hemithorax on the collapsed side
% of pneumothorax= 100-(D23/DH3 x 100)

DOBUTAMINE DRIP
6 X WT in Kg = ______mg in 100ml
250mg in D5W 250cc (1mg/ml)
Mcgtt/min= wt x DD/16.6
= wt x DD x 0.06
500mg in D5W 250cc (2mg/ml)
Mgtts/min = wt x DD/33.2
= wt x DD x 0.03
EPINEPHRINE/NOREPINEPHRINE DRIP
0.6 X WT = ______mg in 100ml
1ml/hr will deliver 0.1mcg/kg/min
Treatment for Chicken Pox
Children: 800mg/tag, 1tab QID
>40mg (3, 200mg PO in 4 divided doses)
Nasal Cannula
Oxygen Flow rate
1
2

Est. FIO2 in %
24%
28%

3
4
5
6

32%
36%
40%
44%

SIMPLE FACE MASK

5-6
6-7
7-8

40%
50%
60%

Anion gap (serum)= Na- (Cl + HCO3)

Corrected Ca= Actual Ca + [(40-alb)x 0.02]
Sodium deficit= DNa-Ana x BW x 0.6
Potassium deficit = DK AK /0.27 x 100%
Sodium

The needed to infuse

DNa-Ana
0.5 meqs / hr
L
Amount of PNSS needed =
Computed Na deficiency 154
Drip rate = amount of PNSS needed
Time needed to infuse

Methylmed
30mkdose + 100cc D5W x 2h q 24H via
infusion pump x 3 doses

SCLEREMA NEONATORUM
In an infant, fat has higher saturated-to-unsaturated fatty acid
ration compared to adult fat and thus a higher melting point.
Prematurity, hypothermia, shock and metabolic abnormalities have
been postulated to further increase this ratio, possibly as a result
of enzymatic alteration allowing precipitation of fatty acid crystals
within the lipocytes. This condition has been suggested to result
in the dramatic clinical findings in affected skin. X-ray diffraction
techniques have confirmed that infants with sclerema neonatorum
have an increase in saturated fats and that the crystals within
the fat cells are composed of triglycerides.

Fluids and Electrolytes

> 5 years old (>20kgs)D5LR
> 3 years old (<15kg)D50.3Nacl/ D5IMB
(>15kg)D5NM
Deficit
Mild
Moderate
Severe

<10 kg
50
100
150

Maintenance (24 H)
0-3 kg
75cc/kg
3-10 kg
100cc/kg
10-20kg
75cc/kg
20-30kg
60cc/kg
30-40kg
50cc/kg
>40kg
40cc/kg
Newborn
0-1 day old
2
3
4
5
6

80cc/kg/hr
90cc/kg/hr
100cc/kg/hr
110cc/kg/hr
120cc/kg/hr
130cc/kg/hr

>10kg
30
60
90

7
8

140cc/kg/hr
150cc/kg/hr

Mild Dehydration
30-50cc/kg/6h
D50.3Nacl
Moderate Dehydration
60-90cc/kg/6h
of computed deficit give D5LRX2hrs then to be given
for the next 6hrs D50.6Nacl
Severe Dehydration
>100cc/kg/6h
1/3 with D5LRX2H then 2/3 with D50.3Nacl X 6H
Medical Prophylaxis
Diphtheria update DPT immunization status for all age
groups and Erythromycin 4-050mkd in 4 days
divided doses X 10 days (max 2g/day).
Alternative: Benzathine Pen G IM single dose

<30kg 600,000 units

>30kg 1.2 Million units

NOTE: Close contact should be observed for 7 days for
evidence of the disease.
Endocarditis prophylaxis given 30-60 mins after procedure

Oral: Amoxicillin 50mg/kg

Unable to tolerate PO
Ampicillin 50mkdose IM/IV or
Cefazolin/Ceftriaxone 50mg/kg
Allergic to Penicillin
Cephalexin 50mg/kg or
CLindamycin 20mg/kg or
Azithromycin/Clarithromycin 15mg/kg
Allergic & unable to tolerate PO:
Cefazolin/ceftriaxone 50mg/kg IM or IV or
Clindamycin 20mg/kg IM or IV
Note: No prophylaxis for procedures ________
Respiratory, GI or Genitourinary Tract

Hepatitis B

Newborn with HBsAg (+) mother

HBIG 0.5mL and Hep B vaccine 0.5ml IM at
birth or w/in 12 hrs followed by Hep B vaccine
at 6 weeks after and after 6 months.

Premature & HbsAg (-) mother

Hep B vaccine delayed until child 2000 gm

Sexual contact with HBsAg (+) partner, exposure to

blood/ body fluids
Hep B vaccine + HBIG 0.06ml/kg IM (not
later than 14 days from exposure from sexual
contact and with in 7 days for percutaneous
exposure)

Household/Sexual Contact with Chronic Causes

Hap B vaccine only

Malaria

Mefloquine (250mg/tab) to start 1 week before travel

then weekly until 4 weeks after leaving endemic area
as ff:

< 45kg = 5mg/kg (max: 250mg)

>45kg = 1 tab once a week

Doxycycline daily to start 2-3 days before travel then

daily until 4 weeks after leaving endemic area

8 years old = 2mg/kg up to adult dose of

100mg/day

Note: Contraindicated for < 8years and pregnant

women

Meningococcemia

Rifampicin in 2 divided doses X 2days

1 month 5mkdose every 12 hrs
1 month 10mkdose every 12 hrs (max 600mg)

Alternative: Ceftriaxone single IM dose

< 15 years old 125mg
15 years old 250mg or
Ceprofloxacin (not for 18 years old)
18 years old: 20mk PO as SD (max 500mg)

Rheumatic Fever

Benzathine Penicillin 1.2 Million U IM every 4 weeks

<27kg (60lbs)- 600,000 U IM or
Penicillin V 250mg PO twice daily for patients
allergic to Penicillin: Erythromycin 250mg PO BID

Duration:
RF, (-) carditis: 5 years since last episode ao
ARF or until 21 years old whichever is longer
RF, (+) carditis w/o residual heart disease (no
valvular disease): 10 years or until 21 years old
whichever is longer
RF, (+) carditis, (+) residual heart disease:
10 years since last episode or at least until 40
years old whichever is longer

Note: Consider lifelong prophylaxis for people with

severe valvular disease

VACCINATION
Absolute Contraindications

Severe anaphylactic/allergic reaction to previous vaccine

Moderate severe illness fever
Encephalopathy within 7 days of vaccine (pertussis)
Immunodeficiency (Congenital all live vaccines ) or
households contact (OPV)
Pregnancy (MMR, OPV/IPV )

Not

Relative Contraindications
Immunosuppressive therapy (all live vaccines)
Egg allergy (MMR)
Seizure w/in 3 days of last dose (Pertussis)
Shock w/in 48 hrs of last dose (Pertussis)
Fever >40.5C w/in 48hrs of last dose (Pertussis)
Contraindications
Mild illness low grade fever
Current antibiotic therapy
Positive PPD
Prematurity
Nursery

Please admit to NICU under the service of Dr. _____

TPR Q15minutes until stable

Breastfeeding

Labs: CBC, APC, BT, RH typing, NBS at 24h old

Medications:
1. Terramycin ophthalmic ointment OU
2. Vit. K 1mg IM
3. Hep B vaccine 0.5mL IM
S/O:
Routine newborn care
Gastric lavage
Suction secretion PRN
Thermoregulate at 36.5-37.5C
Daily cord care w/70% IPA

Watch out for tachypnea, tachycardia, alar flaring,

retractions
Refer PRN

Newborn Final Diagnosis:

Fullterm (__wks), AGA, BW=__kg, cephalic via NSVD,
Live, Bb.Girl/Boy AS 9,10; Neonatal sepsis; Uninvestigated
physiologic jaundice

IVF:

TFR x wt/24h/20% (if with phototherapy)

TFR x wt/24h-fdg-Aminosteril (use formula if
w/ Aminosteril & fdg)
eg: wt: 3kg TFR: 80
80x3/24/20%= 20 or
80x3=240x0.2= 48, next
240/48= 288/24h= 12cc/hr
1st 24h D10w, then
D10IMB
D5IMB
Preterm

Please admit

TPR q15 minutes until stable

NPO

D10W 250ccx7cc/hr
Labs:
CBC, APC @24HDL
Blood & RH typing
Na, K, Ca
BUN, Creatinine
24HDL
NBS
ABG, Blood C/S, CBG q6H
CXR, APL
Vit. K 1mg IM now
Hep B 0.5 ml Im now
Terramycin/Erythromycin ophthalmic ointment
Ampicillin q12h
Oxygen
Attach to pulse oximeter

HBsAg Reactive Mother

Give HBIg 0.5ml deep IM w/in 12HOL
CRP at 24HOL
Blood C/S anytime after birth

Normal CBG: 60-140

Bilirubin: B1B2: 17.1 (start phototherapy if 15)

WBC: 20,000 start meds

IT Ratio- stabs/juvenile/total neutrophils = 0.2 (+)

infection

Reticulocyte actual Hct/0.40 (desired Hct)X

Reticulocyte = N 1-1.5

 1.0 = hemolysis
1 = bone marrow failure (CRT 2)
Seizure Disorder
Please admit
TPR q4h and record
NPO temporarily
Labs: CBS, APC, Urinalysis, fecalysis, CBG now then
q6h while on NPO
IVF: D50.3Nacl 500cc+2meq KCL/150ccIVF post
voiding
Meds:

S/O:

MIO qshift & record

Monitor VS q4h & NVS qhour & record

Seizure precaution at bedside

Standby O2, padded tongue depressor at

bedside

Replace GI loses volume/volume w/ PLR

as sidedrip

Refer PRN
Benign Febrile Seizure
Please admit
TPR q4h & record
NPO temporarily

Labs: CBC, APC, Urinalysis, Fecalysis, CBC now then

q6h while on NPO
IVF: D50.3Nacl 50cc+ 2meq KCl/100cc IVF
IVF post voiding
Meds: Paracetamol, Ibuprofen, Diazepam (0.2mkdose)
S/O:

MIO qshift & record

Monitor VS q4h, neuroVS qhour & record

Seizure precaution

Standby O2, tongue depressor at bedside

Replace GI losses V/V w/ PLR as sidedrip

Refer PRN

Status Post Lumbar Puncture Orders

Flat on Bed x 4h
NPO x 4h
Send the following specimen to lab as ff:

TT#3 CSF cell ct, diff ct

TT#2 CSF, sugar & protein

TT#1 CSF GS/CS, AFB, KOH

RBS now
Monitor VSq15min until stable
Refer patient for any untoward s/sx
Status Post Extubation Orders
Nebulizer with Racemic epinephrine now
Extubate patient now
Nebulize w/ Racemic epinephrine q15minx3doses

 Nebulize w/ Salbutamol 1nebule q6h

NPO x 6h
CXR, APG 6h post extubation
O2 6-10LPM
Watch out for secretions, tachypnea, etc.
Note: Racemic Epi: PNSS: 4.7ml Epi: 0.3ml
Body Surface Area

=
3600

ANC= WBC x Differentials x 10

IT = stabs seg
>0.2 bacterial
BMI = wt (kg) ht (m)2
MIO + intake output = +/- balance
Output + output wt 24h = ____cc/k
(Output of chemo px: output 24hBSA =
_____cc/m2)

Dopamine

0.5-4gm/kg/min renal vasodilation

>10gm/kg/min vasodilation & decreased peripheral

and renal perfusion

5-10 gm/kg/min increase inotropic effect and

cardiac output = increase BP

Management for Acute Respiratory Tract Infection

Central cyanosis
Severe respiratory distress
Not able to drink

YES

Very
Severe
Pneumonia

NO
Chest in drawing

YES

Severe
Pneumonia

NO
Fast Breathing

YES

Pneumonia

NO

No signs of PNA
Fast Breathing:
60BPM in <2 months
50BPM in 2-11 months
40 BPM in 1-5 years

YES

No PNA,
cough, cold

Admit
IV Chloramphenicol/
Ceftriaxone
O2
Tx fever

Admit
PenG
Manage Airway
Tx Fever

Home management
Amoxicillin
Cough remedy
Ff-up in 2 days

Home management
Cough medications
Ff-up in 5 days
Tx fever