[slb0523]

For your pediatric patients that weigh over 50 kg, do you continue to run medication drips at weight based doses?
example:
18 y.o. weighs 54kg. versed drip at 0.1mg/kg/hr or 5.4mg/hr?
There used to be a standard in my picu for patients over 50kg, the drips would not be weight based. (They would be run as adult doses due to their size). They are now trying to make them ALL weight based-no exceptions. I work in a unit that is pedi and adult ICU. Not all nurses are trained for pedi and will take the larger kids at times. They feel uncomfortable running pedi doses on teens that are over 50kg.
what are the standards in your PICU based on weight?

[janfrn]

In the unit whee I used to work, 50kg was the cutoff and everything ran at the 50kg dose, regardless of weight. The unit where I work now (a self-described state-of-the-art, world class center of excellence) uses weight-based dosing for all patients, even our 80kg linebackers. Fairly often we have to remind a physician (resident) that a 70kg kid should NOT be getting 2.1g of cefazolin because the max adult dose is 2g! Or 700mg vancomycin q6h when the adult dose is 500. An epinephrine infusion might be mixed by an inexperienced nurse so that 50mL of solution contains 21mg of drug, even though the maximum recommended concentration is 3.2mg in 50mL. Problematic.

[Rayrae]

Yes... you have to be sure your weight-based dose is NOT bigger than the maximum safe ADULT dose. This depends on the medications. (In other words... what Jan said )