pediatrics

MDM – Sick Neonate (Peds)

MDM, Peds

This is an ill-appearing *** who presents with lethargy. Differential includes sepsis, congenital heart disease, hypovolemia and hypoxemic states, endocrine emergencies like CAH or thyroiditis, trauma, inborn errors of metabolism, seizures, electrolyte derangements, or intestinal catastrophe. Given this undifferentiated sick neonate, will work up broadly, empiric broad-spectrum antibiotics***, trial of 10cc/kg fluid bolus, resuscitative measures and will consider early airway intervention.

 

Pearls: For a sick kid use THE MISFITS:

Trauma: consider FAST and CTH
– consider vitamin K and Ca if bleeding
Heart disease, hypovolemia, hypoxia
Endocrine (CAH, thyrotoxicosis)

Metabolic – lytes
Inborn errors
Seizures
Formula mishaps
Intestinal catastrophes (volvulus, intuss, NEC)
Toxins
Sepsis

DC Inst – Peds Rash

DC, Peds

Your child has been evaluated in the Emergency Department today for a rash. Your child’s rash is most likely due to ***.

Please follow up with your child’s pediatrician within three days.

Return to the Emergency Department immediately if your child has worsening rash, rash that spreads to the mouth or the palms of the hands or soles of the feet, fevers that cannot be controlled with tylenol or motrin, behavior changes, or any other concerning symptoms.

Thank you for choosing us for your child’s care.

DC Inst – Peds MSK (No Fx)

DC, Peds

Your child has been evaluated in the Emergency Department today for *** pain. Your child’s evaluation, including X-rays, did not find signs of any concerning conditions such as fractures or dislocations.

Please rest, ice, and elevate your child’s ***, and resume normal activities as tolerated.

Give your child Tylenol and Ibuprofen per the attached dosing instructions for pain.

Please schedule an appointment with your child’s pediatrician for follow up this week.

Return to the Emergency Department if your child experiences worsening pain, numbness, tingling, change of color in your child’s extremity, or any other concerning symptoms.

Thank you for choosing us for your child’s care.

DC Inst – Peds Fracture

DC, Peds

Male child?????????????????????????

Your son has been evaluated in the Emergency Department today for his ______ pain. His evaluation, including an x-ray of his _____, has revealed a _____ fracture. Your son’s ______ has been splinted in the ER.

Please rest, ice, and elevate your son’s ____ to control pain and inflammation.

Please give your son tylenol/motrin as directed in the attached dosing instructions for discomfort.

Please follow up with a pediatric orthopedic surgeon in about 1 week.

Return to the ER immediately if your son has any worsening or uncontrolled pain, numbness or weakness to his ____, color change to his ____, or for any other concerning symptoms.

Thank you for choosing usfor your child’s care.

Female child??????????????????????????????

Your daughter has been evaluated in the Emergency Department today for her ______ pain. Her evaluation, including an x-ray of her _____, has revealed a _____ fracture. Your daughter’s ______ has been splinted in the ER.

Please rest, ice, and elevate her ____ to control pain and inflammation.

Please give your daughter tylenol/motrin as directed in the attached dosing instructions for discomfort.

Please follow up with a pediatric orthopedic surgeon in about 1 week.

Return to the ER immediately if your daughter has any worsening or uncontrolled pain, numbness or weakness to her ____, color change to her ____, or for any other concerning symptoms.

Thank you for choosing us for your child’s care.

Pediatric Tylenol/Motrin Dosing Chart by Weight

Acetaminophen (Tylenol) Dosing Chart
May give acetaminophen dose every 4 – 6 hours:
Weight Tylenol Milligram Dosage Tylenol Infant drops 80mg/0.8ml Tylenol Children’s liquid160mg/5ml Tylenol Chewables 80mg each Tylenol Junior 160mg each
6 – 8 lbs 40 mg ½ dropper (0.4 ml) N/A N/A N/A
9 – 11 lbs 60 mg ¾ dropper (0.6 ml) N/A N/A N/A
12 – 17 lbs 80 mg 1 dropper (0.8 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 120 mg 1 ½ dropper (1.2 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 160 mg 2 droppers (1.6 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 240 mg 3 droppers (2.4 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 320 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 400 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 500 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Tylenol suppositories can be used if the child is vomiting or is very resistant to taking medicine by mouth. The suppositories can be cut-up to get the proper dose.

Ibuprofen (Motrin / Advil) Dosing Chart
May give ibuprofen dose every 6 – 8 hours:
Weight Motrin Milligram Dosage Motrin Infant drops 50mg/1.25ml Motrin Children’s liquid100mg/5ml Motrin Chewables 50mg each Motrin Junior100mg each
12 – 17 lbs 50 mg 1 dropper (1.25 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 75 mg 1 ½ dropper (1.875 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 100 mg 2 droppers (2.5 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 150 mg 3 droppers (3.75 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 200 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 250 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 300 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Motrin should NOT be given to infants less than 6 months old.

DC Inst – Peds Fever

DC, Peds

Male Child ???????????????????????

Your son was evaluated in the Emergency Department today for his fever. His evaluation, including ***, suggests that his symptoms are due to ***.

Please alternate Tylenol and Motrin every 4-6 hours to help control your son’s fever.

Please follow up with your son’s pediatrician within three days.

Return to the Emergency Department immediately if your son experiences severe cough, fevers greater than 100.4°F that cannot be controlled with Tylenol/Motrin, recurrent vomiting, lethargy, seizures, shortness of breath, or any other concerning symptoms.

Thank you for choosing us for your child’s care.

Female child?????????????????????????????????

Your daughter was evaluated in the Emergency Department today for her fever. Her evaluation, including ***, suggests that her symptoms are due to ***.

Please alternate Tylenol and Motrin every 4-6 hours to help control your daughter’s fever.

Please follow up with your daughter’s pediatrician within three days.

Return to the Emergency Department immediately if your daughter experiences severe cough, fevers greater than 100.4°F that cannot be controlled with Tylenol/Motrin, recurrent vomiting, lethargy, seizures, shortness of breath, or any other concerning symptoms.

Thank you for choosing us for your child’s care.

Pediatric Tylenol/Motrin Dosing Chart by Weight

Acetaminophen (Tylenol) Dosing Chart
May give acetaminophen dose every 4 – 6 hours:
Weight Tylenol Milligram Dosage Tylenol Infant drops 80mg/0.8ml Tylenol Children’s liquid160mg/5ml Tylenol Chewables 80mg each Tylenol Junior 160mg each
6 – 8 lbs 40 mg ½ dropper (0.4 ml) N/A N/A N/A
9 – 11 lbs 60 mg ¾ dropper (0.6 ml) N/A N/A N/A
12 – 17 lbs 80 mg 1 dropper (0.8 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 120 mg 1 ½ dropper (1.2 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 160 mg 2 droppers (1.6 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 240 mg 3 droppers (2.4 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 320 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 400 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 500 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Tylenol suppositories can be used if the child is vomiting or is very resistant to taking medicine by mouth. The suppositories can be cut-up to get the proper dose.

Ibuprofen (Motrin / Advil) Dosing Chart
May give ibuprofen dose every 6 – 8 hours:
Weight Motrin Milligram Dosage Motrin Infant drops 50mg/1.25ml Motrin Children’s liquid100mg/5ml Motrin Chewables 50mg each Motrin Junior100mg each
12 – 17 lbs 50 mg 1 dropper (1.25 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 75 mg 1 ½ dropper (1.875 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 100 mg 2 droppers (2.5 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 150 mg 3 droppers (3.75 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 200 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 250 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 300 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Motrin should NOT be given to infants less than 6 months old.

DC Inst – Child Cough

DC, Peds

Male child:????????????????????

Your son was evaluated in the Emergency Department today for his cough. His evaluation suggests that his symptoms are likely due to a viral illness.

You can give your son Tylenol or Motrin per the attached dosing instructions as needed for fever.

Please follow up with your son’s pediatrician within three days.

Return to the Emergency Department if your son experiences worsening cough, fever 100.4°F or greater, recurrent vomiting, lethargy, or any other concerning symptoms.

Thank you for choosing us for your care.

Female child: ???????????????????????????????????

Your daughter was evaluated in the Emergency Department today for her cough. Her evaluation suggests that her symptoms are likely due to a viral illness.

You can give your daughter Tylenol or Motrin per the attached dosing instructions as needed for fever.

Please follow up with your daughter’s pediatrician within three days.

Return to the Emergency Department if your daughter experiences worsening cough, fever 100.4°F or greater, recurrent vomiting, lethargy, or any other concerning symptoms.

Thank you for choosing us for your care.

Pediatric Tylenol/Motrin Dosing Chart by Weight

Acetaminophen (Tylenol) Dosing Chart
May give acetaminophen dose every 4 – 6 hours:
Weight Tylenol Milligram Dosage Tylenol Infant drops 80mg/0.8ml Tylenol Children’s liquid160mg/5ml Tylenol Chewables 80mg each Tylenol Junior 160mg each
6 – 8 lbs 40 mg ½ dropper (0.4 ml) N/A N/A N/A
9 – 11 lbs 60 mg ¾ dropper (0.6 ml) N/A N/A N/A
12 – 17 lbs 80 mg 1 dropper (0.8 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 120 mg 1 ½ dropper (1.2 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 160 mg 2 droppers (1.6 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 240 mg 3 droppers (2.4 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 320 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 400 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 500 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Tylenol suppositories can be used if the child is vomiting or is very resistant to taking medicine by mouth. The suppositories can be cut-up to get the proper dose.

Ibuprofen (Motrin / Advil) Dosing Chart
May give ibuprofen dose every 6 – 8 hours:
Weight Motrin Milligram Dosage Motrin Infant drops 50mg/1.25ml Motrin Children’s liquid100mg/5ml Motrin Chewables 50mg each Motrin Junior100mg each
12 – 17 lbs 50 mg 1 dropper (1.25 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 75 mg 1 ½ dropper (1.875 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 100 mg 2 droppers (2.5 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 150 mg 3 droppers (3.75 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 200 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 250 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 300 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Motrin should NOT be given to infants less than 6 months old.