Any help with learning meds?

[spenac]

Ok, memorize them for your test.

But in a stressful situation your memory regarding the pediatric dosages is going to go out the window.

There is nothing wrong with using a field guide or pamphlet put out by a reputable childrens hospital to quickly review a dosage for adenosine or epinephrine on a 5kg patient.

In fact, a prominent pediatric intensivist at Childrens Mercy Hospital told me one day "It's criminal not to use a guide, the first thing to go in a critical child call is gonna be your drug dosage memory"

Not saying that this is what will happen to you or anyone on here since we all are "AWESOME PROVIDERS" but to those of us who are not awesome providers I can take all the help I can get when I get a critical kid. Why do you think we have the broselow chart/bag???(way to overpriced if you ask me though)

I agree fully Ruff. I am a firm believer in double checking in the field. sadly though schools and many services require you be able to quote everything about the drugs.

I use my field guide or even open the protocol book to confirm dosages as I would rather delay 15 seconds than kill someone because I gave MG rather than mcg.

[medic82942003]

I did the tape recorder thing, then got a good field guide. Also carried a Breslow tape.

Flash cards work good. just remember kids are not just little adults. Be safe.

I once read that we forget 50 percent of what we memorized in 6 months. IE 6 months after

school. Cheers. Its just like knowing dosage calc for IV drips. you hardly use it in the field.

[tniuqs]

Jeepluv77:

Just one med at a time memory wise ... you will do fine ... for kids the HUGE thing is estimation of weight with Rx dosage.

Sorry Spenac: I hate that stoopid Brainless Broselow Tape "so what if you can't find it ?" Your hooped.

Its back to basics and with it "Brainless Broselow Tape" length equates to WT ONLY with it and just averages. We know EBM that this is NOT the way to go in real life practice, as under dose vs over dosage with Epi as is a big area of error in the Paeds population studies in hospital prove it.

So, here is what I do.

I walk around in grocery stores make contact and with every munckin I can, make small talk with the MOMs ... then guestimate age and weight, Moms usually know and its great practice and when you tell the MOMs why your asking ... they are usually MORE than helpful.

Yea Ok "initially" the MOMS think I am an axe murderer but then I use my Paramedic charm and explain WHY I am bugging them and thier Kids, they open up huge It works awesome and picking the kids up does't hurt either, DO NOT TRY TO PICK UP THE MOMS a recipe for a good sound BEATING! te he but "lifting" the kids that can be too much to ask, so being a Male, I try watermelons, pineapples and sweet potatoes, as there is always a scale in the store to see how accurate you are.

The Palm Pilot program called PEPID studied over dose vs under dosage extensively and in hospital it prove conclusively that plastic brains are far superior. (Rosenbloom et all)

FIRST get the dose mg's per Kilo in your memory, THEN use a reference chart and if you have a plastic brain/ chart in your pocket thats the way to go.

So .... ETT look at the little finger (forget the math when it comes to real life) and start at 4.0, for any kid over "shinyand fresh" mind you I have worked in NICU and Paeds Units so that comes easy to me.

Length of the ETT at the upper lip far more challenging, talk to an RRT to get your tape method down pat ... as you don't want to loose that damn tube! Trust your ears and if you have capabilities of side stream ETCO2 sampling and knowing the mls per minute rate as a sample volume, hence know your monitor too, as rapid changes in ETCO2 are awesome indicator.

SpO2 ... use the big toe, or the heel.

BP for the exam ok ... real life its a waste of time most cases if its not NIBP and serial (like q 1 or 2 minutes) cap refil way better indicator bedside.

Lines: IO is absolutely the way to go ... FLUID is a huge deal with kids resus ... 20 mls per Kilo x 3 or 4 as it winds them up like a toy doll REALLY, REALLY.

Be confident as kids are far more rate dependent than force.

Steal a "practice" IO and while your in that grocery store chatting with the MOM's, pick up a few chicken legs and thighs ... THEN after practice your off to the BBQ ... honey mustard is my fave.

Controversy:

I just recertified in PALS ... this Epi S/S for all suspected Croup BHAH ! ... as an RRT I am so NOT an advocate Epi S/S inital rx, as it is a huge hammer, as it can make kids more tachycardic (affecting preload, and dumping B/P) it short acting it can be refractory and can because your sitting beside the Kid ... AFFECT YOU TOO ! The last thing one needs as a provider. I will go Albuterol and throw in some Atrovent and observe.

For exam quote epi but in real practice .... well its your call.

Passing the exam is one thing ... passing the real life exam, Really Sick Kids are the Hardest Challenge that you will face ... IMHO.

cheers

Edited August 30, 2009 by tniuqs

[FireMedic65]

Of course there is nothing wrong with double checking your meds. I have several programs on my phone/pda for it. Many times you just draw a blank when there is tons of other stuff going on. But, she asked for help on studying for her test

[brentleymetcalf]

Where can I find these Phone/PDA programs? I carry a Palm Treo.

[tniuqs]

PEPID website.