Archive for the ‘emergency’ Tag

Paediatric RSI Drug Dosages (KKH)   Leave a comment

please note that these dosages are recommended for an Asian population residing in Singapore.
 

Age weight Atropine Succinylcholine Midazolam Etomidate Ketamine
dose 0.01-0.02mg/kg 1mg/kg* 0.1-0.3mg/kg 0.3mg/kg 1-2mg/kg
2m 5kg 0.1mg NA 0.5-1.5mg 1.5mg 5-10mg
6m 8kg 0.16mg 12mg 0.8-2.4mg 2.4mg 8-16mg
1y 10kg 0.2mg 15mg 1-3mg 3mg 10-20mg
3y 15kg 0.2mg 15mg 1.5-4.5mg 4.5mg 15-30mg
5y 19kg 0.4mg 19mg 2-6mg 5.7mg 19-38mg
7y 23kg 0.5mg 23mg 2.5-7mg 6.9mg 23-46mg
9y 29kg 0.6mg 29mg 3-9mg 8.7mg 29-58mg
11y 36kg 0.6mg 36mg 3.5-11mg 10.8mg 36-72mg
12y 44kg 0.6mg 44mg 4.5-13mg 13.2mg 44-88mg
14y 50kg 0.6mg 50mg 5-15mg 15mg 50-100mg
16y 58kg 0.6mg 58mg 15mg 17.4mg 58-116mg
Adult 65kg 0.6mg 65mg 15mg 19.5mg 65-130mg

*succinylcholine: dose 1.5mg/kg for <10kg; second dose is contraindicated in infants and young children (increased risk of bradycardia, asystole)

Atropine pre-medication is required in:

  • all <1y/o
  • bradycardic
  • children receiving succinylcholine
  • adolescents and adults receiving 2nd dose of succinylcholine
  • when ketamine is used

 
Special indications:

  • head injury with no hypotension: use midazolam/thiopental
  • hypotension: use ketamine or not at all
  • status asthmaticus: use ketamine; thiopentone contraindicated

CURB-65 score for Community-Acquired Pneumonia   Leave a comment

5-point score for defining community acquired pneumonia severity on presentation to hospital.
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San Franciso Syncope Rule   Leave a comment

to evaluate patient with syncope
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When to do CT head for minor head injury?   Leave a comment

Canadian CT Head Rule here.