Peds Med calculations during a code

[Guest1059175]

Hi I was wondering how nurses calculator pediatric medication dosages during a emergency/code since everything is mostly weight based. Do most nurses use a calculator or are u able to do the math correctly in your head?

[Wuzzie]

I do it in my head but there is such a thing called a Broselow tape which has been in use for years. It is especially useful for units that don't do many pediatric codes.

Broselow tape - Wikipedia

Sorry to use Wickipedia but it was honestly the most comprehensive hit I could find on the net.

[AdobeRN]

With all admissions our charge nurse printed a "code sheet" - had patients admit weight and all medications dosages used in a code calculated out - we would tape it to wall above head of bed. I want to say it was a spreadsheet that either pharmacy made up for us or one of the nurses made it.

[HandmadeRN]

Our hospital (in the UK) uses a mnemonic called WETFLAG. Each child has a sign behind their bed with these letters and the admitting nurse or bedside nurse will complete the relevant information next to the letters. W = Weight, E = Energy (joules), T = Tube, Fl = Fluids, A = Adrenaline, G = Glucose. Any clinician/nurse that attends the code or resus can immediately see this information.

[NotReady4PrimeTime, RN]

I really like the WETFLAG mnemonic, Freya008.

On the three units I've worked, two had manually calculated emergency drug sheets for each patient. When the admistting weight was known, the admitting nurse filled out the sheet using provided dosages, ie: atropine 0.02 mg/kg, max 0.6 mg. _________ mg My current unit has an Excel spread sheet created by our clin.pharm. person. At the top of the form the admitting nurse or unit clerk enters weight and age, the software does the rest. Those are kept at the bedside for each patient. For resus situations outside the PICU we use the Broselow tape, or the emergency drug manual that sits on each of our crash carts. This manual is organized by 0.5 kg increment weights and provides a table for each. This is usually adequate for all but the smallest patients.

[KelRN215, BSN, RN]

When I worked in the hospital, there was a book of drug cards on our code cart that included the dose of various code drugs for patient's weights by kg.

I worked in peds neuro and our most common cause for codes was status epilepticus. The standard dose of ativan for prolonged seizures is 0.1 mg/kg which is easy enough math to do in one's head. I did catch an error during a code once though where an MD called for "0.1 of ativan." He meants 0.1 mg/kg and the child weighed 13 kg. I was handed a syringe drawn up with 0.2 mL of ativan. IV ativan is 2 mg/mL so what I was handed was 0.4 mg. It was the wrong dose based on what the nurse heard/thought she was drawing up (0.1 mg) and what the MD intended (0.1 mg/kg= 1.3 mg).

[Wuzzie]

Also wanted to add that some monitors (HP for sure) will calculate a drug sheet for you.

[Thanksforthedonuts, BSN, RN]

During my clinical rotations in Peds I noticed that they had a typed paper attached to the vitals

Monitor. It has weight listed. And a list of dosages for some of medications typical in codes.

[NICU Guy, BSN, RN]

Each baby has a code sheet on their bed and in their chart. They are reprinted every Sunday with their updated weight. There is no calculating during a code.

[HandmadeRN]

Thank you NotReadyforprimetime!