paed 2

Question 1

moderate croup mx?

Answer 1

• Dexamethasone 600 mcg/kg Oral (Max. 12 mg)
• Tx
• Rx as Severe if Pt deteriorates

Question 2

severe croup mx/?

Answer 2

• Adrenaline 5 mg (5 mL) Nebulised (1:1,000)
• Dexamethasone 600 mcg/kg Oral (Max 12 mg)

if unimproved:
• Repeat Adrenaline as above at 5
minute intervals until improvement

Question 3

mild/mod mx of asthma

Answer 3

• Salbutamol pMDI and spacer
- > 6 years Salbutamol 4 - 12 doses
< 2 - 6 Salbutamol 2 - 6 doses

• Pt to take 4 breaths for each dose
• Repeat at 20 minute intervals if required

—– no significant response after 20 - mx as severe

Question 4

severe mx of asthma?

Answer 4

• Nebulised Salbutamol

• Small children (2 - 4 years): Salbutamol 2.5 mg (1.25 mL) nebulised
• Medium children (5 - 11 years):
  Salbutamol 2.5 - 5 mg (1.25 - 2.5 mL) nebulised
• Repeat Salbutamol at 20 minute intervals if required

• Ipratropium Bromide 250 mcg (1 mL) nebulised

Question 5

critical asthma mx

Answer 5

• Nebulised Salbutamol
- All children (2 - 11 years): Salbutamol 10 mg
(5 mL) nebulised
- Repeat Salbutamol at 5 minute intervals if
required

• Ipratropium Bromide 250 mcg (1 mL) nebulised

Dexmetasone 600mcg/kg oral (12mg max)

• If unable to gain IV or unaccredited in IV Adrenaline:
- Adrenaline 10 mcg/kg IM (1:1000)
- Repeat at 5 - 10 minute intervals as required
(max 30 mcg/kg IM)

Question 6

undifferentiated n/v Prophylaxis for
• Awake Pt (GCS 13-15) with potential spinal
injuries and immobilised
• Eye trauma – e.g. penetrating eye injury or
hyphema

Answer 6

• Ondansetron ODT orally

• Small child – 2 mg
• Medium child – 4 mg

Question 7

glucagon doses (2)

Answer 7

• If not accredited in IV Dextrose or no IV access:

• < 25 kg Glucagon 0.5 IU IM (0.5 mL)
• > 25 kg Glucagon 1 IU IM (1 mL)

Question 8

mx for pt that has poor response to oral glucose?

Answer 8

glucagon

• If not accredited in IV Dextrose or no IV access:

• < 25 kg Glucagon 0.5 IU IM (0.5 mL)
• > 25 kg Glucagon 1 IU IM (1 mL)

Question 9

midaz doses in seizures (nb/sml&large infant/SC/MC).

Answer 9

• Midazolam IM

• Medium Child (5 - 11 years) Midazolam 2.5 - 5 mg IM
• Small child (1 - 4 years) Midazolam 2.5 mg IM
• Small & Large Infant (< 12 months) Midazolam 1 mg IM
• Newborn Midazolam 0.5 mg IM

– activity continues - rpt original dose once only at 10/60 min.

Question 10

ceftriaxone dose.

Answer 10

• Ceftriaxone 50 mg/kg IM (max. 1000 mg)
- Dilute 1000 mg with 3.5 mL
Lignocaine 1%
- Administer into upper lateral thigh

Question 11

opiod od mx?

Answer 11

• Assist and maintain airway / ventilation
• Naloxone 10 mcg/kg (max. 400 mcg) IM

rpt same dose if required at 10/60min.