Some of you may have known the age of the child in this post from experience, others may have had no clue.
In the comments there was a wide range of values, and it is indeed difficult to guess the weight of a child if you aren’t with them. But the point of the post was to get us thinking about why we base our peds doses on weight and how we arrive at that weight. There were comments about carrying a backup broselow tape (I spelled it right this time), but is that really the answer?
I understand the usefulness of a field guide and having a broselow tape in my peds bag is one of the first things I look for in that kit.
But I am also confident in knowing that if it is lost, stolen, damaged or suddenly switched for a BeeGees Best of Compilation that I can take a deep breath and do my job without it.
I am not better than anyone else because I feel comfortable with peds calls. I can’t handle dislocated fingers. That’s my Achilles heel, or finger, if you prefer.
Again, the goal of this You Make the Call game was to get you to remember what you are trained to do when all the fancy tools, bells and whistles are gone. Anyone claiming “BLS before ALS” needs to start with the simple deduction of size, age and weight of the patient.
We do it for Dopamine on adults, but don’t carry large cheat sheets to lay next to them. Why do we rely on one for kids?
The young lady in the photo was 4 weeks old and weighed 9 pounds.
If you were way off, no big deal, keep that tape handy. But next time you have a peds patient ASK the parents how much they weigh and remember it for reference. We also learned a quick reference rhyme in P school, hopefully you did too. It’s the 1-5-10, 10-20-30 ratio. Meaning a 1 year old should weigh in around 10 kilos. A 5 year old at 20, and a 10 year old at 30. These are guidelines to establish if a suspected weight is within reason. Don’t grab a one year old and start dosing at 10 kilos without a proper assessment. Also keep in mind that a child’s diet, heredity and, believe it or not, race could be a factor as well.
A wonderfully designed system being adopted by hospitals can be found here, along with photos of children to represent their sizes and color coded dosages of medications. But keep in mind your concentrations of those medications may be different and if you don’t know what the value should be, there is no way the guide can help you.
Take a few minutes to wander the Color Coding Kids site, a lot of common sense stuff there.
See you next week when our patients get bigger. Much bigger.