To supplement our new pediatric reference cards, I've included some things in this e-mail which were not covered.
Weight Gain
Proper weight gain is 25-30 grams/day for first 4-6 months.
After 4-6 months patients should double their birth weight.
Patients regain birth weight by 10-14 days.
Pediatric Fluid Resuscitation
Bolus: 20mL/kg
Remember, in sepsis can do 3x bolus = 60 mL/kg
Maintenance Fluids - The 4-2-1 rule
Add the following for each 10kg of body weight:
4mL/kg
2mL/kg
1mL/kg
e.g. 24 kg child = (4mL*10mL/kg) + (2mL*10mL/kg) + (1mL*4mL/kg) = 64 mL/kg
Pediatric Dextrose/Hypoglycemia Resuscitation
The dextrose Rule of 50
Multiple your % dextrose solution supplied in ED by the ml/kg to give to patient to give and set equal to 50
In other words, divide 50 by the % dextrose solution you have available
For D10: 10X=50 i.e. give 5mL/kg of D10
For D25: 25X=50 i.e. give 2mL/kg of D25
For D50: 50X=50 i.e. give 1mL/kg of D50
Pediatric wet diaper output
Proper output is 1-2ml/kg/hr
Practically, patients should have 4-6 wet diapers per day.
Remember to base this off patient's "normal" as some parents do not change diapers as often.