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

2. 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

3. 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.

4. 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)

5. 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)

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

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

8. 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

9. 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)

10. 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

11. 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

12. 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)

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

14. Oral Airways

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

16. Endotracheal Tubes and Suction Catheters

17. LMA Sizes

18. 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

19. Chest Tube Sizes

20. Nasogastric Tubes

21. Urinary Catheters

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

23. 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

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

25. Questions

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