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You are told that you will be receiving a 12 month old child in full arrest. CPR is in progress by the paramedics. Your EMS agency does not have pre-hospital providers intubate children. Which of the following is true as you prepare your equipment and medications?
Kelly January 25, 2022 - 11:50 pm
D) You should prepare a 1 Miller or 1-1.5 Wis-Hipple laryngoscope blade
Equipment sizing and medication dosing are some of the most difficult parts of practicing pediatrics. One should always have a quick reference available – either length-based resuscitation tape, mobile phone app, or chart. The average 12 month old will weigh ~10 kg. Cuffed tubes can now be used (and are preferred) in all but neonates. The formula is [age (yrs) / 4 + 4] for uncuffed tubes; subtract 0.5 for cuffed tubes, so this patient would use a 3.5 cuffed. Asystole is by far the most common rhythm for pediatric cardiac arrest. Epinephrine 0.1mg/mL (formerly called 1:10,000) solution is given at 0.1 mL/kg in pediatric resuscitation, so you would be dosing 1mL of this; if you used 1mg/mL (1:1000) solution you would be dosing 0.1mL. A femoral line in this age group would be sized at 4F, but you should be preparing for an IO line; central lines will take too long to place. There are LMAs available for neonates > 1.5-2kg, although there are reports of use in premies as small as 800gm.