Pediatric Anesthesia and Emergency Drug Guide

408 Pages·2015·2.39 MB·English

by  Lynn Fitzgerald Macksey

Pediatric
Anesthesia and
Emergency Drug
Guide
SECOND EDITION
Lynn Fitzgerald Macksey, MSN, RN, CRNA
Department of Anesthesiology
University of North Carolina at Chapel Hill School of Medicine
Chapel Hill, North Carolina
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Library of Congress Cataloging-in-Publication Data
Names: Macksey, Lynn Fitzgerald, author.
Title: Pediatric anesthesia and emergency drug guide / Lynn Fitzgerald Macksey.
Other titles: Pediatric anesthetic and emergency drug guide
Description: Second edition. | Burlington, Massachusetts : Jones & Bartlett Learning, [2017] | Preceded by Pediatric
   anesthetic and emergency drug guide / Lynn Fitzgerald Macksey. c2009. | Includes bibliographical references.
Identifiers: LCCN 2015038830 | ISBN 9781284090987
Subjects: | MESH: Anesthesia--methods--Nurses’ Instruction. | Anesthetics--administration & dosage--Nurses’
   Instruction. | Emergencies--Nurses’ Instruction. | Pediatrics--methods--Nurses’ Instruction.
Classification: LCC RD139 | NLM WO 440 | DDC 617.9/6083--dc23
LC record available at http://lccn.loc.gov/2015038830
6048
Printed in the United States of America
19 18 17 16 15 10 9 8 7 6 5 4 3 2 1
Lynn Fitzgerald Macksey, MSN, RN, CRNA
iii
iv
To Keith, Kevin, and Kimberly,
my greatest teachers
Contents
Disclaimer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
Section.1:.Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Section.2:.Normal.Vital.Signs,.Weight,.and.H&H. . . . . . . . . 7
Normal.vital.signs.per.age. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Pediatric.estimated.weight.and.BSA.formulas. . . . . . . . . . . . . . . . . . . . . 9
Pediatric.normal.weights.per.age. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Normal.Hgb/Hct.at.specific.ages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Section.3:.Pediatric.NPO.Guidelines,.Fluids,.Colloids,..
and.Blood.Products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
NPO.guidelines.prior.to.surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
IV.fluids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Colloid/Blood.products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Section.4:.Pediatric.Circuits,.Intubation.Equipment,..
Mac,.and.Volatile.Inhaled.Anesthetics. . . . . . . . . . . . . . . . .19
Pediatric.circuits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Blade.and.vent.bag.per.weight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Pediatric.syndromes.associated.with.difficult.airway. . . . . . . . . . . . . . 26
MAC.of.volatile.inhaled.anesthetics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
v
Contents vi
Inhaled.induction.with.volatile.anesthetics. . . . . . . . . . . . . . . . . . . . . . 27
General.information:.inhaled.anesthetics. . . . . . . . . . . . . . . . . . . . . . . . 28
Pediatric.uptake.and.distribution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Section.5:.Pediatric.Anesthesia.Equipment..
and.Drug.Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Nasal.intubations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Emergency.drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Pediatric.induction-maintenance.drugs.setup.for.pediatrics. . . . . . . .37
Section.6:.Pediatric.Pharmacology:.Perioperative..
and.Emergency.Drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Synopsis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Top.considerations.of.anesthetic.selection.in.pediatrics. . . . . . . . . . . 43
Drug.dosages.and.ranges.listed.alphabetically. . . . . . . . . . . . . . . . . . . 44
Emergency.drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Section.7:.Neonatal.Pearls,.Diseases,.Emergencies,..
and.Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Neonatal.pearls.(age.1–28.days). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Common.neonatal.emergencies.and.anesthetic.management. . . . . 299
Common.neonatal.disease.and.anesthetic.management. . . . . . . . . .320
Section.8:.Pediatric.Pearls,.Diseases,.Emergencies,..
and.Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Pediatric.pearls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Pediatric.diseases,.emergencies,.procedures,..
and.anesthetic.management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336
Abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399
Contents vii
viii
Disclaimer
The author, editor, and publisher have made every effort
to provide accurate information. However, they are not
responsible for errors, omissions, or for any outcomes
related to the use of the contents of this book and take no
responsibility for the use of the products and procedures
described. Treatments and side effects described in this
book may not be applicable to all people; likewise, some
people may require a dose or experience a side effect that
is not described herein. Drugs and medical devices are
discussed that may have limited availability controlled by
the Food and Drug Administration (FDA) for use only
in a research study or clinical trial. Research, clinical
practice, and government regulations often change the
accepted standard in this field. When consideration is
being given to use of any drug in the clinical setting,
the health care provider or reader is responsible for
determining FDA status of the drug, reading the package
insert, and reviewing prescribing information for the most
up-to-date recommendations on dose, precautions, and
contraindications, and determining the appropriate usage
for the product. This is especially important in the case of
drugs that are new or seldom used.
SECTION
1
Introduction