If we have to do a manual on a baby we use a doppler, impossible to hear with a stethoscope. However, we very rarely do manuals at all. If we get an 'off' reading I often leave the cuff on and dinamap attached, swaddle the baby up and leave it for 5mins to settle, then creep in and hit 'go' again!! haha.
Wow you US guys do things differently! I'm a paeds nurse in the UK. We give paracetemol (tylenol) 15-20mg/kg max qds, ibuprofen (motrin) 5-10mg/kg max tds.
You guys have to get local creams ordered in the US? (I'm guessing that means prescribed!?) We use ametop or emla on most kids for IV insertion and it doesn't need to be prescribed. We can just decide to give it as nurses with no doctor input.