C-NPT flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Pediatric hypotension thresholds

Systolic below 70 mmHg in term neonates, below 70 plus twice the age in years for children 1 to 10 years, and below 90 mmHg over 10 years.

Shock index in children

Heart rate divided by systolic blood pressure; values above 1.0 suggest occult or decompensated shock, while normal values are about 0.7 to 0.8.

Length-based weight estimation

A resuscitation tape estimates weight and equipment sizes from body length for children under about 12 years or 36 kg when age is unknown.

Pediatric trauma scene time

Aim for scene time under 10 minutes in critically injured children, prioritizing airway, hemorrhage control, and rapid transport over on-scene procedures.

Lung-protective tidal volumes

Use 4 to 6 mL/kg predicted body weight in neonatal and pediatric ARDS, and 6 to 8 mL/kg for children with normal lungs.

Respiratory time constant

Compliance multiplied by resistance; allow at least three time constants for exhalation to prevent air trapping and auto-PEEP during mechanical ventilation.

Inhaled nitric oxide weaning

Start at 20 ppm for persistent pulmonary hypertension of the newborn; wean FiO2 first, then nitric oxide, because abrupt discontinuation causes rebound pulmonary hypertension.

Surfactant dosing volumes

Poractant alfa 2.5 mL/kg initially with 1.25 mL/kg for later doses, and beractant 4 mL/kg per dose, instilled intratracheally early in respiratory distress syndrome.

Neonatal cardiac output

About 200 to 250 mL/kg/min, roughly three times the adult index, so neonates depend heavily on heart rate to maintain cardiac output.

Prostaglandin E1 for ductal lesions

Infuse 0.05 mcg/kg/min to keep the ductus arteriosus open; apnea occurs in roughly 10 to 12 percent of infants, so airway readiness is essential.

Pediatric fluid bolus

Give 10 to 20 mL/kg of isotonic crystalloid over 5 to 20 minutes and reassess after each bolus; use caution with large volumes when cardiac dysfunction is present.

Epinephrine infusion range

0.05 to 0.3 mcg/kg/min for fluid-refractory shock, titrated to perfusion and blood pressure; monitor for tachycardia, hypertension, and hyperglycemia.

Therapeutic hypothermia for HIE

Cool infants of at least 36 weeks' gestation with moderate to severe encephalopathy to 33.5 degrees Celsius for 72 hours, starting within 6 hours of birth, then rewarm slowly.

Neonatal seizure first-line therapy

Phenobarbital 20 mg/kg IV loading dose, with another 10 mg/kg if seizures persist; levetiracetam 40 to 60 mg/kg is a common alternative.

Modified verbal GCS

Children under 2 years are scored on sounds and crying (coos, cries, inappropriate cry, irritable, no response) rather than orientation, with a maximum of 5.

Cerebral perfusion pressure

Mean arterial pressure minus intracranial pressure; preventing hypotension and hypoxia preserves cerebral perfusion in pediatric traumatic brain injury.

Holliday-Segar maintenance

4 mL/kg/h for the first 10 kg, plus 2 mL/kg/h for the next 10 kg, plus 1 mL/kg/h for each kilogram above 20.

Neonatal hypoglycemia treatment

Give 2 mL/kg of D10W (0.2 g/kg) intravenously for glucose below 45 mg/dL, then recheck the level in 30 minutes and start a continuous infusion.

Glucose infusion rate formula

GIR in mg/kg/min equals percent dextrose times milliliters per hour, divided by six times weight in kilograms; typical neonatal target is 4 to 8.

Suspected NEC management

Stop enteral feeds, decompress with a nasogastric tube, obtain cultures, and give broad-spectrum antibiotics; pneumatosis intestinalis is the classic radiographic finding.

Epinephrine arrest dose

0.01 mg/kg (0.1 mL/kg of 1:10,000) IV or IO every 3 to 5 minutes; the endotracheal dose is 0.1 mg/kg of 1:1,000.

Adenosine for SVT

0.1 mg/kg rapid IV push (maximum 6 mg), then 0.2 mg/kg (maximum 12 mg), each followed by an immediate saline flush.

Racemic epinephrine for croup

Nebulize 0.05 mL/kg of the 2.25 percent solution (maximum 0.5 mL) diluted to 3 mL, and observe at least 2 to 4 hours because symptoms can rebound.

Amiodarone arrest dose

5 mg/kg IV or IO, maximum 300 mg, for ventricular fibrillation or pulseless ventricular tachycardia; infuse over 20 to 60 minutes if a pulse is present.

Neutral thermal environment

Ambient conditions in which oxygen consumption is minimal and core temperature is normal; preterm infants need higher temperatures because of a high surface-area-to-mass ratio.

Four mechanisms of heat loss

Evaporation, conduction, convection, and radiation; in neonates, evaporation from wet skin and radiation to cool surfaces cause the greatest heat losses.

Altitude effect on oxygenation

Falling barometric pressure lowers alveolar oxygen tension, so flow and FiO2 must increase; trapped gas also expands, overinflating endotracheal tube cuffs and pneumothoraces.

Oxygen cylinder duration formula

Minutes equal gauge pressure in psi minus 200, multiplied by the cylinder factor (0.28 for an E cylinder), divided by flow in liters per minute.

Four-point isolette restraint

Incubators are strapped to the vehicle at four points and every monitor, pump, and cylinder is secured because unrestrained items become projectiles during deceleration.

SBAR handoff

A structured communication format using Situation, Background, Assessment, and Recommendation, applied to medical control reports and receiving-team handoffs.

EMTALA transfer requirements

United States law requires stabilizing treatment and an appropriate transfer, with physician certification of benefit and documented acceptance by the receiving facility.

Informed consent in transport

Consent from a parent or guardian is required before treatment and transport; an emergency exception applies when delay would risk life or limb.