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9) PALS: This section details the
Pediatric Advanced Life Support protocols just as the ACLS section
demonstrated above. This should be explored by the
user.
10) PediCode: provides all
you need to know about over 30 emergency drugs and interventions
often needed for the treatment of critically ill children.
Sepsis Example: An average
sized infant of 9 months presents with no measurable blood
pressure and diminished mental status. The parents indicate the
child has had a couple of hours of decreased alertness, fever,
and 1 episode of vomiting.
You attach the child to a monitor and find a heart rate of 300
with a narrow complex consistent with SVT. A peripheral line is
not readily available.
Select PediCode
Select the MeanWt from the Calculator Pad and choose ‘9 Mos
8.9 kg"Select Cardioversion as the initial treatment for
unstable SVT is synchronized cardioversion.
The program will then show you the result for Cardiovert at 0.5,
1.0 and 2.9J/kg. A single synchronized shock is delivered at 5
Joules and the SVT resolves.
The skin signs and mental status remain poor and the BP is now
50/p.
It is decided that you may also be dealing with a septic
condition and so want to see the infant’s response to a
20mL/kg NS bolus and other sepsis treatment.From the drop down
selector, select ‘Sepsis’Items needed for a septic child are
automatically displayed, including fluid bolus and much
more.After some improvement in pressure to 70/p, mental status
remains poor and petechiea are noted on the extremities.
Your concern for Sepsis and meningococcemia increases so you
want to treat accordingly.
The results now give comprehensive recommendations for this
condition based on the patients weight including fluids, drips,
antibiotics, and all relevant tube sizes and catheters. In this
example, you want to administer Ceftriaxone and Ampicillin and
unfortunately need to intubate the child and place a Foley
catheter to evaluate for urinary source (tube sizes are listed
on this single screen).
11) PediDrips: calculates
critical care drips commonly needed for Pediatric patients.
So in the example we just used, the infant is transferred to the
PICU and despite fluid boluses requires triple pressors to
maintain minimal blood pressure. Epinephrine, Dopamine and
Dobutamine are sequentially added via continuous infusion.
Go to the drop down module list (Right upper corner) select
PediDrips
Press Enter on the Weight Entry as 8.9 Kilograms is still
displayed from prior entry in PediCode
Select Epinephrine and choose the desired dosing and
concentration. In this case, we initiate therapy with 1
mcg/kg/min using a 32 mcg/mL solution. After selections are
made, press the ‘Result’ button.The results page now
displays the confirmation of the selections made. Mixing,
Infusing and compatibility information are easily available by
pressing the appropriate buttons on the screen. You would follow
a similar process for Dopamine then Dobutamine.
It is important to note that the "Rule of 6’s"
calculations are automatically made and appear on the Infusion
screen for those who prefer to use rule of 6’s rather than
fixed concentration. This is available for Dopamine, Dobutamine,
Epinephrine and Terbutaline.
12) PediDrugs:
Provides dosing calculations for a wide variety of Pediatric IV,
PO, IM medications from antibiotics to cardiac medications.
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