jwraider Posted August 30, 2008 Share Posted August 30, 2008 I have some conflicting dosage requirements in my protocols and I'm wondering what you guys would do if faced with a similair problem. It's fairly likely the protocol is just not clear so if that's the case please let me know! For example: Pediatric Bradycardia The protocol states to use the Broselow tape for medications that are underlined. Epinephrine is listed as 0.01mg/kg 1:10,000 q3-5 no max and underlined. On the Broselow tape for a 33KG child the dose would be 0.33mg. Now look at this other page in the protocol book supposedly listing drugs and dosages not covered in on the Broselow tape: Pediatric Dose Chart You'll notice there is a 0.1mg max listed for 1:10,000 Epi.... so how do I not go against one of the protocols? Valium has a similair issue where in the protocol it lists a max of 5mg Pediatric Seizure but the drug is underlined and reffering to the tape shows dosages exceeding 5mg (6.6mg for a 30-36kg kiddo). So do I stop at 5mg or follow the Broselow and give a 6.6 mg dose? Any ideas on what line of thought you would take to approach the contradictions? I'm really not sure where to place more weight. The protocols say to use the tape then don't specify exactly when not to if there is a conflict. My preceptor said he would document all dosages calculated per Broselow tape and go with what the tape says. I'd prefer to do a mix of following the valium max of 5mg but use the tape for epi because a 12 yeard old that ways 50kg probably needs more than 0.1mg. I don't think that's a good idea though it would be hard to defend myself if I didn't commit to one line of thinking. I'd really like to be able to follow protocol as a new medic and student! p.s. here is an example of a protocol with non underlined neds: Prediatric Respiratory Distress (lower) Thanks for reading and sorting through my mess =) Link to comment Share on other sites More sharing options...
Doczilla Posted August 30, 2008 Share Posted August 30, 2008 I have some conflicting dosage requirements in my protocols and I'm wondering what you guys would do if faced with a similair problem. It's fairly likely the protocol is just not clear so if that's the case please let me know! For example: Pediatric Bradycardia The protocol states to use the Broselow tape for medications that are underlined. Epinephrine is listed as 0.01mg/kg 1:10,000 q3-5 no max and underlined. On the Broselow tape for a 33KG child the dose would be 0.33mg. That is the IV dose for cardiac arrest, not bradycardia or anaphylaxis with a pulse, which is what your supplemental dose chart is referring to. Now look at this other page in the protocol book supposedly listing drugs and dosages not covered in on the Broselow tape: Pediatric Dose Chart You'll notice there is a 0.1mg max listed for 1:10,000 Epi.... so how do I not go against one of the protocols? That is the IV dose for epi in patients not in cardiac arrest. You want to give them a lighter dose, or you risk life threatening dysrhythmia. Valium has a similair issue where in the protocol it lists a max of 5mg Pediatric Seizure but the drug is underlined and reffering to the tape shows dosages exceeding 5mg (6.6mg for a 30-36kg kiddo). So do I stop at 5mg or follow the Broselow and give a 6.6 mg dose? I recommend following the protocol, not the tape. Link to comment Share on other sites More sharing options...
jwraider Posted August 30, 2008 Author Share Posted August 30, 2008 awesome thanks Doczilla that clears up epinephrine. All the other discrepencies I found can be answered by following the tape but stopping at the max listed in the protocol. Thanks again. Link to comment Share on other sites More sharing options...
JTpaintball70 Posted August 30, 2008 Share Posted August 30, 2008 We're taught that if the ped dose exceeds the normal adult doseage, just go with the adult dose Link to comment Share on other sites More sharing options...
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