IV bolus

[re8]

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Hi there,

I was wondering which one is the correct IV bolus amount for a hypovolmic pediatric patient?

10 ml/Kg or 20 ml/Kg?

As I know, it is allowed to use anything between 10-20ml/Kg..but I got a multiple choice questions listed both 10 and 20?
Thanks

 

[oldbearprofessor]

Hi there,

I was wondering which one is the correct IV bolus amount for a hypovolmic pediatric patient?

10 ml/Kg or 20 ml/Kg?

As I know, it is allowed to use anything between 10-20ml/Kg..but I got a multiple choice questions listed both 10 and 20?
Thanks

I always give 15 mL/kg so I'd have missed it too.🙄

The usual is 10 mL/kg, but in some cases you give more, so it's a poorly written question.

Edit: As noted by J-Rad, I am referring to neonates, who are "pediatric", but of course if they mean older kids, then it's different. In general don't worry too much about missing badly worded questions.....

 

[J-Rad]

Generally: if the patient is at an age when you'd be using PALS algorithms* for resuscitation (which I would take from the "pediatric patient" wording) the dose is 20ml/kg**

For a neonate, for whom you'd employ NRP algorithms, the dose is 10ml/kg***.


*In clinical reality, there isn't a distinct age at which you would continue to use NRP vs. PALS. For example, if a four-day-old has SVT, you will essentially use PALS algorithms, since NRP doesn't really cover this.

**Not part of your question, but furthermore: guidelines for treatment of shock go on to say 20ml/kg boluses, give up to and over 60ml/kg within the first 15 minutes of resuscitation (this is Carcillo's verbiage; that wording didn't quite make it into the '05 update to PALS; I'm not sure if it made it into the '10 update)

***As already alluded to by OBP, 10ml/kg isn't an inviolate rule, but a guideline. You may, at times, bolus a neonate with larger doses.

 

[blanche]

Excepting neonates and anyone you are concerned may have cardiac insufficiency/failure, I think 20 cc/kg is a safe bet. When I was a hedging intern, I ordered a 10 cc/kg bolus once or twice before the attending told me to start ordering boluses like I meant it.

 

[rotatores]

Excepting neonates and anyone you are concerned may have cardiac insufficiency/failure, I think 20 cc/kg is a safe bet. When I was a hedging intern, I ordered a 10 cc/kg bolus once or twice before the attending told me to start ordering boluses like I meant it.