Pediatric Equipment and Supplies Presented by: Danyel Dorn RN, MSN, CPN CLINICAL NURSE EDUCATOR-Pediatric Service Line

Purpose Perianesthesia registered nurses must be aware that “one size fits all” does not apply to pediatric patients. Obtaining basic common assessments and performing common procedures requires an added dimension of thought and availability of appropriate equipment and supplies that are suitable for the pediatric patient

Competency Statement The RN caring for the pediatric patient will be able to identify and determine equipment for basic pediatric assessment and care contingent upon age, weight and physical limitations.

Adverse Outcomes Medical and treatment errors can possibly occur if faulty information is obtained by lack of pediatric sized equipment Adverse Outcomes include Medication calculation errors Vital sign measurement errors Potential physical harm to the pediatric patient (i.e., tracheal injury due to oversized airway)

Pediatric Emergency Equipment Commonly used pediatric drugs available with dosing reference for weight Size-appropriate backboard Cardiac defibrillator designed for pediatric use, appropriate joules and pads (found on Crash-cart)

Height, Length, and Weight Measurement Standing scale (with measuring bar) Bed scale Infant scale Tape measure

Vital Sign Measurement Thermometer Infant, pediatric, adult stethoscopes Penlight Appropriate pulse oximetry probes (infant, child, and adult)

Blood Pressure Cuffs Child = cuff should cover approximately 2/3 upper arm or thigh Adult = width of bladder should be roughly 40% the circumference of the arm and length of the bladder should cover about 80% of the circumference of the arm NOTE: Cuff name does not always mean it is size-appropriate for the child

IV Catheters 16-24 gauge catheters (most common 22-24g) IO needles (18g for infants, 15-16g for young children, 12g for older children) Use appropriate items for extremity warming (chemical pack warmers and warm blankets)

Phlebotomy Use appropriate blood-sparing tubes (CBC 0.5ml) Butterfly catheters 23-25g Umbilical vein catheters Central venous catheters sizes 6-12 Fr Blood/fluid warmer

Pediatric Med Administration IM injections: 20-22g, ½-1 ½ inch needles (depending on child’s age, size or injection site) Utilize various sizes of oral medications syringes Intradermal injections (i.e., tuberculin syringes 25-27g, ¼ to 5/8 inch needles) Use filter needles when drawing medications from glass ampules

IV Solutions for Infants/Children Small vials 10% Dextrose 100, 250, and 500 ml bags of common IV solutions Ensure IVF is on micro-tubing and utilize a Burette for infants < 12 months Utilize IV pumps capabile of delivering small infusion rates (PEDS PCA Pump)

Thermoregulation Devices Infant warmers Warming lights Forced air warming devices Warm blankets-Swaddle

Oral Airways

Nasopharyngeal Airways Measure the distance from nares to angle of mandible Nasopharyngeal airway available in 12-36 Fr sizes Shortened endotracheal tube may be used in infants or small children

Endotracheal Tubes and Suction Catheters

LMA Sizes

Oxygen Delivery Devices Nasal Cannulas-Infant, pediatric and adult Simple mask Partial rebreather Flow Meter-standard or a flow meter that has the ability to deliver low flow below 1 liter with accuracy Venturi mask, trach collar, nebulizers, Jackson-Reese, Ambu Bag Trach tubes of various sizes-always keep a spare-same type ½ smaller or same size- must be at bedside and travel with the child throughout the hospitalization

Chest Tube Sizes

Nasogastric Tubes

Urinary Catheters

Pediatric Broselows Cart Color Coded Weight Based Kept in Clean Supply Room-Trauma Pacu and in 2-Central

Nutritional Supplies Appropriate methods of feeding- Breast Fed, PO, GT, cleft palate Always start post-operative with clears: pedialyte, 5% Glucose water for babies less than 6 months old, breast milk Flavored pedialyte, apple juice, popsicles Then advance to Saltine crackers, graham crackers If tolerated then advance to formula or milk

Reference ASPAN (2016). A Competency Based Orientation and Credentialing Program for the Registered Nurse Caring for the Pediatric Patient in the Perianesthesia Setting

Questions

Answers 1. D - Standing Scale 2. B – 3.0 3. C – 8 French 4. A – 8-10 Nasogastric tube 5. A – 8 Suction Catheter