Normal vital signs:
Newborn – 3 mo
3-12 mo
1-10 yr
>10 yr
Heart rate Respiratory rate
Systolic BP
80 - 200
30 - 60
>60
80 - 180
24 - 50
>70
60 - 150
22 - 40
>70 + 2(age in yrs)
60 - 120
12 - 30
>90
Modified GCS:
Eye Opening
Verbal
Response
Motor
Response
Infants
Open spontaneously
Open in response to verbal
stimuli
Open in response to pain
No response
Coos and babbles
Irritable cry
Cries in response to pain
Moans in response to pain
No response
Moves spontaneously and
purposefully
Withdraws to touch
Withdraws in response to pain
Responds to pain with
decorticate posturing
Responds to pain with
decerebrate posturing
No response
Children
Open spontaneously
Open in response to verbal
stimuli
Open in response to pain
No response
Oriented, appropriate
Confused
Inappropriate words
Incomprehensible words or
sounds
No response
Obeys commands
Localizes painful stimulus
Withdraws in response to pain
Responds to pain with
decorticate posturing
Responds to pain with
decerebrate posturing
No response
Formulas to help in a crunch:
Weight (in kg):
Age <9yo = 2(age) + 9
Age>9yo = 3(age)
ETT size:
Uncuffed = (age/4) + 4
Cuffed = (age/4) + 3.5
ETT depth of insertion:
3 x size of ET
NG size:
ETT size x 2
Chest tube size:
ETT size x 4
ETT size for newborns:
Weight
Gestational Age
<1000g
24-28 wks
1000-2000g
28-34 wks
2000-3000g
34-38 wks
>3000g
>38 wks
Insertion depth (cm) = Wt (kg)+ 6
ETT size
2.5
3.0
3.5
3.5-4.0
Basic Life Support:
Breaths
(without compressions)
Breaths
(with compressions)
Compression rate
Compression – ventilation
ratio
Adult
(adolescent and
older)
10-12
Child
(1yo – adolescent)
Infant
(<1yo)
15-20
15-20
8-10
8-10
8-10
100
30:2
100
15:2
100
15:2
Newborn
(has not left
hospital yet)
40-60
100
3:1
Resuscitation Drugs:
Drug
Adenosine
Alprostadil (PGE1)
Amiodarone
Atropine
Calcium chloride 10%
Dobutamine
Dopamine
Epinephrine
Hydrocortisone
Lidocaine
Magnesium
Methylprednisolone
Milrinone
Naloxone
Norepinephrine
Procainamide
Sodium bicarbonate
Dosage
SVT
0.1mg/kg (max 6mg); 2nd dose 0.2mg/kg (max 12mg)
Ductal dependent CHD
0.05 – 0.1 mcg/kg/min initial infusion
SVT/VT with pulse
5mg/kg load over 20-60 min (max 300mg)
VF/pulseless VT
5mg/kg bolus (max 300mg)
0.02mg/kg (min 0.1mg; max 0.5mg child; max 1mg
adolescent)
20mg/kg (0.2mL/kg) slow push
2-20mcg/kg/min
2-20mcg/kg/min
Pulseless arrest, bradycardia
0.01mg/kg (0.1mL/kg) 1:10 000 IV q3-5min (max 1mg)
0.1mg/kg (0.1mL/kg) 1:1000 in ETT
Anaphylaxis
0.01mg/kg (0.01mL/kg) 1:1000 IM q15min (max 0.5mg)
Hypotensive shock
0.1-1mcg/kg/min
Adrenal Insufficiency
2mg/kg (max 100mg)
VF/pulseless VT, wide-complex tachy with pulse
1mg/kg bolus and 20-50mcg/kg/min infusion
Asthma, Torsades de Pointes, Hypomagnesemia
25-50mg/kg (max 2g) bolus (pulseless VT), over 10-20min
(VT with pulse), over 15-30min (status asthmaticus)
Asthma, Anaphylaxis
2mg/kg (max 80mg)
50-75mcg/kg over 10-60min then 0.5-0.75mcg/kg/min
Opioid reversal
0.1mg/kg (max 2mg) for complete reversal
0.01mg/kg and titrate to effect for partial reversal
0.1-2mcg/kg/min
SVT, VT (with pulses)
15mg/kg over 30-60min
1-2mEq/kg
Neonatal Resuscitation