Anesthesia Student Survival Guide.pdf - Index of

362 ● AnesthesiA student survivAl Guide
diverse range of weight and body habitus. Table 22.4 shows the choice of endotracheal
tube diameter and length based on patient’s age and weight. Table 22.5
shows the choice of laryngoscopic blade and LMA size based on patient’s age.
Table 22.6 shows the most common pediatric emergency drug dosages.
Intravenous Fluids
Intravenous fluid management is based upon calculating the sum of the NPO
deficit, ongoing maintenance, blood loss (if any), and the potential for surgically
induced fluid shifts (also see Chap. 14, Electrolytes, Fluid, Acid–Base and
Transfusion Therapy). The formula most often applied is commonly known as
the “4-2-1 rule” (see below). Crystalloid solutions, normal saline or Lactated
Ringer’s fulfill the majority of basic needs. Glucose infusions are used for the
newborn or premature infant because of their limited glycogen stores.
Since many young children may still have partially patent shunts, all air
bubbles should be evacuated from intravenous tubing prior to administration
to prevent paradoxical air embolism and catastrophic cardiovascular collapse.
Table 22.4 Endotracheal tube sizes and appropriate insertion depths.
Age/weight Internal diameter (mm) Length (oral) in cm Length (nasal) in cm