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.