color coding kids: the broselow-luten system
TRANSCRIPT
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Color Coding Kids:The Broselow-Luten System
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Institute of Medicine Report
Deaths: 44,000 to 98,000
Cost: 17 to 29 Billion Dollars
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Lesar study
Medication error rate in tertiary care center
– Greatest areasPediatrics
Emergency Department
– Pediatrics: reliance on dosage equations was major cause of error
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Kaushal JAMA Study 4/01
Included major Children’s Hospital
5.7% of orders had medication errors
Dosing error most prevalent category
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Institute for Safe Medication Practices (ISMP)Pediatric Pharmacy Advocacy Group (PPAG)
– “Pediatric patients need more protection from medication errors, survey shows”
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Two Key Pediatric Error Issues
1) Dependence upon calculations
2) Lack of familiarity with normal vs. abnormal
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1993 1995
Number 34 30
Greater than1 error 19 9
Ten fold errors 3 4
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Didn’t recognize errors
ICU Patients 10 drugs orders per day.
Could translate to one 10-fold error for each 10 infants
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Recognizing normal
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Even The Cleaning lady would know!!
“Too many amps in the trash”
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Which dose is 10 times error?
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ADJUSTED BROSELOW-LUTEN ZONES
Zone CM Length Wt in KgAge in months
1 Pink 59.5-66.5 6-7 2-52 Red 66.5-74 8-9 5-113 Purple 74-84.5 10-11 11-194 Yellow 84.5-97.5 12-14 19-305 White 97.5-110 15-18 30-39.56 Blue 110-120.75 19-23 39.5-62.57 Orange 120.75-133.4 24-29 62.5-838 Green 133.4-146.5 30-36 83-107.5
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Mathematical Accuracy of New Zones
Average variation from “rounded” Kg dosing for each zone or practical difference between per Kg and zone dosing: 4%
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RED
PURPLE
YELLOW
WHITE
ORANGE
GREEN
BLUE
PINK 6-7KG
8-9KG
10-11KG
12-14KG
15-18KG
19-23KG
24-29KG
30-36KG
Standard Pediatric system
Gray 3kgGray 4kgGray 5kg
Gray Zones
Round to the nearest whole kilogram
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RAINBOW TAPE
YELLOW
DRUGS and EQUIPMENT
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“Prescribing system”
A standardized pre-calculated color-coding dosing system
May be used in all therapeutic environments
(not protocol driven)
Two formats: 1) rainbow pages 2) rainbow stripes
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Rainbow Page Format
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Rainbow Stripe Format
TIDAL VOLUME 60-100mL 75 - 125mL 100-150mL 125-200mL 150-250mL 200-300mL 250-400mL 350-500mL
VENTILATION
FREQUENCY(BPM) 20 - 25 20 - 25 15 - 25 15 - 25 15 - 25 12 - 20 12 - 20 12 - 20
Parameters: FiO2 100%, PEEP 3 cm H2O, Inspiratory Time >0.6 sec, PIP 2030 cm H2O, Tidal Volume 10-15 mL/kg—Start low and increase to PIP 20-20 cm H2O
BOLUS ( mL) 130 170 210 260 325 420 530 660
FLUIDS
MAINTENANCE (mL/hr) 28 35 40 45 55 65 70 75
ZONE PINK RED PURPLE YELLOW WHITE BLUE ORANGE GREEN
ZONE PINK RED PURPLE YELLOW WHITE BLUE ORANGE GREEN
MINIMUM HOURLY URINE OUTPUT (mL/hr)
7-14 9--18 10-20 13-25 16-32 20-40 25-50 35-65
NOTE: The 3, 4, 5 kg weights are not part of the color coded system.The following applies to these Patients : VENTILATION Rate same as pink and red, Tidal Volume, Fluid- 3kg 1/2 (50%) pink zone, 4kg 2/3(67%) pink zone, 5kg 3/4(75%) pink zone values.
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Drug administration by protocol
1)Standardized Dosing2)Medication ordering by
Protocol … Guide or “Key Word”3) Dose in mLs4) Information organized by Point of care “Flow Guides”
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Dosing by “Key word”
Midazolam InductionMidazolam SedationDiazepam- sedation IV Diazepam-Seizure IV*Diazepam-seizure-RECTALDiphenhydramine IVPancuronium DefasciculationPancuronium InductionPancuronium MaintenanceVancomycin IVVancomycin
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Protocol dosing in Guide Book Format
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HYPERKALEMIA FLOW CHART
Give Calcium Chloride IV over 3-5 minutes, may repeat in 10 minutes
Albuterol neb
Initial Stabilzation
Initial Stabilzation
First LineDrugs
First LineDrugs
AncillaryMeasure
AncillaryMeasure
Long termPreventiveLong termPreventive
Give Sodium Bicarbonate IV over 5-10 minutes
Give Glucose and Insulin IV over 30 minutes, may repeat immediately
Kayexalate PO,NG, or PR
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INSULIN DILUTIONPREPARATION
Add 1 mL(100 units) regular Insulin to 100 mL NS.Final concentration of
Insulin dilution= 1unit/mL
DEXTROSE IV
0.25 g/mL 26 mL
INSULIN IV
1.3 mL
13 mL 0.5g/mL (Dilute 1:1 with NS/D5W)
1 unit/mL as prepared above
CALCIUM CHLORIDE IV
100 mg/mL
GLUCAGON IV (IM,SC-see Alternative Routes section)
1 mg/mL 0.5 mL
CALCIUM GLUCONATE IV
100 mg/mL 13 mL
(Infuse over 3 minutes, may repeat in 10 minutes )
(Infuse over 3 minutes, may repeat in 10 minutes)
GLUCOSE AND INSULIN IV DRIP
+ 1.3 mL INSULIN
27.3 mL TOTAL
(Infuse TOTAL mLs over 30 minutes, may repeat in 30-60 minutes)
26 mL DEXTROSE
2.6 mL
YELLO
W
12-14 kg
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ZONE3.5 uncff
10 - 10.5
8F
50 MM
4.5 uncff
12.5-13.5
10F
6F
60 MM
5.0 uncff
14- 5
10F
6F
60 MM
4.0 uncff
11 - 12
8 - 10F
6F
60 MM
5.5 uncff
15.5-16.5
10F
14F
70 MM
6.0 cuff
17-18
10F
14F
80 MM
6.5 cuff
18.5-19.5
12F
14F
80 MM
3.5 uncff
10 - 10.5
8F
6F
50 MM
PINK RED PURPLE YELLOW WHITE BLUE ORANGE GREEN
1 straight2 straight/
curved2 straight/
curved1 straight
2 straight/curved
2-3 straight/curved
2-3straight/curved
1 straight
6F
ET Tube(mm)Lip-Tip (cm) Suction L-Scope bladeStylet Oral Airway
PEDIATRIC/DETECTOR
CHILD
PEDIATRIC/DETECTOR
CHILD
ADULT/DETECTOR
CHILD
PEDIATRIC/DETECTOR
CHILD
ADULT/DECTECTOR
CHILD/ADULTADULT/
DETECTOR
ADULT
ADULT/DETECTOR
INFANT
PEDIATRIC/DETECTOR
14F 20F 22F18F 24F 26F 30F14F
INFANT
NP Airway BVM ETCO2
EQUIPMENT
Defib (1stdose) 13j 17j 20j 26j 33j 42j 53j 66j
Cardioversion
26j 34j 40j 52j 66j 84j 106j 132j
ZONE PINK RED PURPLE YELLOW WHITE BLUE ORANGE GREEN
7j 8j 10j 13j 17j 21j 27j 33j
DEFIBRILLATION - CARDIOVERSION
Defib ( 2+ doses)
NOTE: The 3, 4, 5 kg weights are not part of the color coded system.The following applies to these Patients : EQUIPMENT- same as pink and red. Defibrillation,Cardioversion 3kg 1/2 (50%) pink zone, 4kg 2/3(67%) pink zone, 5kg 3/4(75%) pink zone values.
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DRUG PINK RED PURPLE YELLOW WHITE BLUE ORANGE GREEN
5.6 7.2 9.5 11 15 19 24 30Amoxicillin
(HIGH DOSE)
400mg/5mL
1.5 2 2.5 3 4 5 6.5 8
Acetaminsuspension
3
3.1
4
4 5
6
6.2
8
8
10
10
13
12.5
16
15
5Amoxicillin125mg/5mL
Amoxicillin250mg/5mL
COMMON ORAL MEDICATIONS (mLs)
Acetamindrops 1 1.3 1.6 2 2.5 3.2 4 5
1.8 2.5 3.6 4.6 6 7.5 9.23cefdinir125mg/5mL
3 4 6.5 8 10 13 16.55 Ibuprofensuspension
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RSI FLOW CHART(Medications)
Lidocaine-RSI IV Fentanyl-RSI IV Atropine-RSI IV Pan/vecuronium-Defasiculation IV
ParalyticsSuccinylcholine IVRocuronium-Paralysis IVPan/vecuronium-Paralysis IV
Induction Agents Etomidate-Induction IVKetamine Induction IVMidazolam-Induction IVThiopental-Induction IVPropofol-Induction IV
Paralysis MaintenancePan/Vec/Rocuronium-maintenance IV
Sedation MaintenanceLorazepam IV, or other
PreparationPreoxygenation
PreparationPreoxygenation
PretreatmentPretreatment
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
Post IntubationManagement
Post IntubationManagement
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Atropine-RSI/RESUS IV
PreparationPreoxygenation
PreparationPreoxygenation
PretreatmentPretreatment
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
ParalyticsSuccinylcholine IV, orRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IV
Paralysis MaintenanceVecuronium maintenance IV
Sedation Maintenance Lorazepam IV
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Post IntubationManagement
Post IntubationManagement
K+ Risk +ICP Poor Perfusion AsthmaGen Sequence
RSI FLOW CHART
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PreparationPreoxygenation
PreparationPreoxygenation
PretreatmentPretreatment
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Post IntubationManagement
Post IntubationManagement
Atropine-RSI/RESUS IV
ParalyticsRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IV
Paralysis MaintenanceVecuronium maintenance IV
Sedation Maintenance Lorazepam IV
+ICP Poor Perfusion AsthmaGen Sequence
RSI FLOW CHARTK+ Risk
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PreparationPreoxygenation
PreparationPreoxygenation
Pretreatment*Pretreatment*
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
Post IntubationManagement
Post IntubationManagement
Atropine-RSI/RESUS IVLidocaine-RSI IV
ParalyticsRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IV
Paralysis Maintenance Vecuronium maintenance IV
Sedation Maintenance Lorazepam IV
K+ Risk Poor Perfusion AsthmaGen Sequence
RSI FLOW CHART+ICP
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Atropine-RSI/RESUS IV
PreparationPreoxygenation
PreparationPreoxygenation
PretreatmentPretreatment
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45 sec
Paralysis MaintenanceVecuronium maintenance IV
Sedation Maintenance Lorazepam IV
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Post IntubationManagement
Post IntubationManagement
ParalyticsSuccinylcholine IV, orRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IVorKetamine Induction IV
K+ Risk +ICP AsthmaGen Sequence
RSI FLOW CHARTPoor Perfusion
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Atropine-RSI/RESUS IV
PreparationPreoxygenation
PreparationPreoxygenation
PretreatmentPretreatment
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
ParalyticsSuccinylcholine IV, orRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IVorKetamine Induction IV
Paralysis MaintenanceVecuronium maintenance IV
Sedation Maintenance Lorazepam IV
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Post IntubationManagement
Post IntubationManagement
K+ Risk +ICP Poor Perfusion AsthmaGen Sequence
RSI FLOW CHART
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Putting it together
5 year old “Broselow Tape Red Zone”Hit on head with baseball bat
Glasgow Coma score is 6BP 130/100 pulse 90 Respirations
20
Needs airway management and is at risk for elevated ICP
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PreparationPreoxygenation
PreparationPreoxygenation
Pretreatment*Pretreatment*
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
Post IntubationManagement
Post IntubationManagement
Atropine-RSI/RESUS IVLidocaine-RSI IV
ParalyticsRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IV
Paralysis Maintenance Vecuronium maintenance IV
Sedation Maintenance Lorazepam IV
K+ Risk Poor Perfusion AsthmaGen Sequence
RSI FLOW CHART+ICP
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PreparationPreoxygenation
PreparationPreoxygenation
Pretreatment*Pretreatment*
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
Post IntubationManagement
Post IntubationManagement
Atropine-RSI/RESUS IVLidocaine-RSI IV
ParalyticsRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IV
Paralysis Maintenance Vecuronium maintenance IV
Sedation Maintenance Lorazepam IV
K+ Risk Poor Perfusion AsthmaGen Sequence
RSI FLOW CHART+ICP
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Blue 19-24 KGS
ATROPINE
1m g/mL 0.42 mL
0.8mg/mL 0.53mL
20 mg/mL 1.6 mLFENTANY L –RSI IV
50 mcg/mL 1.3 mL
VECURONIUM-Defasiculation IV
1 mg/mL 0.2 mL
10 mg/mL 3.2 mLLIDOCAINE-RSI IV
ROCURONIUM –Defasiculation IV
2 mg/mL 0.1 mL
10 mg/mL 0. 2mL
0.4mg/mL 1 mL
PRE-TREATMENT MEDICATIONS
0.5mg/mL 0.84mL
0.05 mg/mL 8.4 mL
PANCURONIUM-Defasiculation IV
1 mg/mL 0.21 mL
0.1mg/mL 4.2 mL
(Give over 60-90 seconds)
Pretreatment Medications
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PreparationPreoxygenation
PreparationPreoxygenation
Pretreatment*Pretreatment*
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
Post IntubationManagement
Post IntubationManagement
Atropine-RSI/RESUS IVLidocaine-RSI IV
ParalyticsRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IV
Paralysis Maintenance Vecuronium maintenance IV
Sedation Maintenance Lorazepam IV
K+ Risk Poor Perfusion AsthmaGen Sequence
RSI FLOW CHART+ICP
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ETOMIDATE- Induction IV
2m g/mL 3.2mL
50 mg/mL 0.84mL
MIDAZOLAM-Induction IV
1 mg/mL 6.3 mL
100 mg/mL 0.42 mLK ETAMINE-Induction IV
5 mg/mL 1.3 mL
10 mg/mL mL
INDUCTION AND PARALY TIC AGENTS
PROPOFOL-Induction IV
10 mg/mL 6.3 mL
10 mg/mL 4.2 mL
THIOPENTAL-Induction IV
25 mg/mL 3.4 mL50 mg/mL 1.7 mL
SUCCINY LCHOLINE
20 m g/mL 2 mL50 mg/mL 0.8 mL
100 mg/mL 0.42 mLVECURONIUM-Paralysis IV
1 mg/mL 0.2 mL
2 mg/mL 2.1 mL
PANCURONIUM-Paralysis IV
1 mg/mL 4.2 mL
ROCURONIUM-Paralysis IV
10 mg/mL 2.1 mL
Blue 19-24 KGS
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PreparationPreoxygenation
PreparationPreoxygenation
Pretreatment*Pretreatment*
Paralysis/Induction
Paralysis/Induction
PlacementPlacement
Zero minus5-10min
Zerominus3min
Zero
Zeroplus45sec
Post IntubationManagement
Post IntubationManagement
Atropine-RSI/RESUS IVLidocaine-RSI IV
ParalyticsRocuronium-Paralysis IV
Induction AgentEtomidate-Induction IV
Paralysis Maintenance Vecuronium maintenance IV
Sedation Maintenance Lorazepam IV
K+ Risk Poor Perfusion AsthmaGen Sequence
RSI FLOW CHART+ICP
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VECURONIUM-Maintenance
1 mg/mL 2.1 mL
LOREZEPAM
2 mg/mL 0.5 mL4 mg/mL 0.25 mL
POST INTUBATION AGENTS
ROCURONIUM-Maintenance
10 mg/mL 0.21 mL
2 mg/mL 1 mL
PANCURONIUM-maintenance
1 mg/mL 2.1 mL
Blue 19-24 KGS
Post Intubation Agents
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Are We " Dumbyfying" Medicine?
Math free algorithms enhance “critical thinking “
“Transparency” of critical decisions promotes team approach to error
reduction
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Point of Care functional units
ALSRSIAnaphylaxisPain and SedationFluids and burnsWeapons of Mass destructionSeizures, electrolytes, etc
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BURNS--------PINK
Body Surface Area Percentages for PINK zone
7%
4%
7%
3%
1) Determine % BSA of patient’s burn2) Refer to fluid charts for hourly rate for
patient’s burn
Front Back
Minimum Urine output 7-13 mL/hr
Morphine IV, IM 0.65-1.3mg
Demerol IV, IM 6.5mg
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10%
%Burn
12mL/hr
RateFor 7 hrs
30% 36mL/hr40% 50mL/hr50% 60mL/hr
20% 25mL/hr
60% 70mL/hr
80% 96mL/hr90% 107mL/hr
70% 86mL/hr
Presentation1 hr post burn
2) Piggy Back Fluid (Maintenance D5W+1/4 NS) Presentation1hr Post Burn
Presentation2hr Post Burn
Presentation3hr Post Burn
Presentation4hr Post Burn
50mL/hrFor 7hrs
58mL/hr for6hrs
70mL/hrFor 5hrs
88mL/hrfor4hrs
1) Resuscitation Fluid (LR)
Presentation > 4hr Post Burn*If > 4 hr.s post burn, start fluids at 4hr post burn rate, treat shock with 20mL/kg fluid boluses, and consult burn center for further fluid guidelines
Presentation 2hr post burn
Presentation3 hr post burn
Presentation4 hr post burn
%Burn
RateFor 6 hrs
%Burn
RateFor 4 hrs
%Burn
RateFor 5 hrs
100% 120mL/hr
Rate for 7hrs Rate for 6 hrs Rate for 5 hrs Rate for 4 hrs
10% 21mL/hr
30% 63mL/hr40% 88mL/hr50% 106mL/hr
20% 44mL/hr
60% 125mL/hr
80% 170mL/hr90% 188mL/hr
70% 150mL/hr
100% 213mL/hr
10% 17mL/hr
30% 50mL/hr40% 70mL/hr50% 85mL/hr
20% 35mL/hr
60% 100mL/hr
80% 135mL/hr90% 150mL/hr
70% 120mL/hr
100% 170mL/hr
10% 14mL/hr
30% 42mL/hr40% 58mL/hr50% 70mL/hr
20% 29mL/hr
60% 83mL/hr
80% 113mL/hr90% 125mL/hr
70% 100mL/hr
100% 142mL/hr
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Emergency infusions
Standard Pediatric System
Neonates
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RED
PURPLE
YELLOW
WHITE
ORANGE
GREEN
BLUE
PINK 6-7KG
8-9KG
10-11KG
12-14KG
15-18KG
19-23KG
24-29KG
30-36KG
Standard Pediatric system
Gray 3kgGray 4kgGray 5kg
Gray Zones
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RED
PURPLE
YELLOW
WHITE
ORANGE
GREEN
BLUE
PINK 6-7KG
8-9KG
10-11KG
12-14KG
15-18KG
19-23KG
24-29KG
30-36KG
Standard Pediatric system
Gray 3kgGray 4kgGray 5kg
Gray Zones
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RAINBOW TAPE
Purple
DRUGS and EQUIPMENT
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mcg/kg/min2
mcg4
mcg6
mcg8
mcg10
mcg12
mcg14
mcg16
mcg18
mcg20
mcg0.8mL
1.6mL
2.4mL
3.2mL
4mL
4.7mL
5.5mL
6.3mL
7mL
8mL
PURPLE 10-11KG
mLs/hour
Maintenance Fluids
42 mLs/hr #1Dopamine 1600 micrograms/mL
B-L Concentration
Infusion bag label applied by pharmacist
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# 1
B-L Concentration
Dopamine 6400 Micrograms/mL
Infusion bag label from pharmacy or manufacturer
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mcg/kg/min2
mcg4
mcg6
mcg8
mcg10
mcg12
mcg14
mcg16
mcg18
mcg20
mcg0.8mL
1.6mL
2.4mL
3.2mL
4mL
4.7mL
5.5mL
6.3mL
7mL
8mL
PURPLE 10-11KG
mLs/hour
Maintenance Fluids
42 mLs/hr #1Dopamine 1600 micrograms/mL
B-L Concentration
Infusion bag label applied by pharmacist
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Newborn System
Pink
Miceronates(up to 1 Kg)
Red Blue
Purple Orange
White
Yellow Green
Pink
Red
Blue
Purple
yellow
White
Green
Orange
Elefants (1Kg to 4.5 Kg)
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Pink1001-1250 GMS
Red 1251-1500 GMS
Blue 2501-3000 GMS
Purple 1501-1750 GMS
Yellow 1751-2000 GMS
White 2001-2500 GMS
Green3751-4500 GMS
Orange 30001-3750
Elefants
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mcg/kg/min2
mcg4
mcg6
mcg8
mcg10
mcg12
mcg14
mcg16
mcg18
mcg20
mcg0.2mL
0.4mL
0.8mL
1mL
1.4mL
1.8mL
2.2mL
2.6mL
3mL
3.6mL
mLs/hour
Maintenance Fluids
12 mLs/hr #1Dopamine 1600 micrograms/mL
B-L Concentration
Blue 2501-3000 GMS
Newborn infusion sticker
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Miceronates
Pink501-550 GMS
Red551-600 GMS
Blue751-800 GMS
Purple601-650 GMS
Yellow651-700 GMS
White701-750 GMS
Orange801-900 GMS
Green901-1000 GMs
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# 2
B-L Concentration
Dopamine 6400 Micrograms/mL
Infusion bag label from pharmacy or manufacturer
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mcg/kg/min2
mcg4
mcg6
mcg8
mcg10
mcg12
mcg14
mcg16
mcg18
mcg20
mcg0.2mL
0.4mL
0.8mL
1mL
1.4mL
1.8mL
2.2mL
2.6mL
3mL
3.6mL
mLs/hour
Maintenance Fluids
2 mLs/hr #2Dopamine 6400 micrograms/mL
B-L Concentration
Pink501-550 GMS
Newborn infusion sticker
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mcg/kg/min2
mcg4
mcg6
mcg8
mcg10
mcg12
mcg14
mcg16
mcg18
mcg20
mcg0.2mL
0.4mL
0.8mL
1mL
1.4mL
1.8mL
2.2mL
2.6mL
3mL
3.6mL
mLs/hour
Maintenance Fluids
12 mLs/hr #1Dopamine 1600 micrograms/mL
B-L Concentration
Blue
Newborn infusion sticker
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Purple10-11KG 8 %
Broselow-Luten color Per Cent of maintenance Fluid requirements
Scroll barScroll bar
4
mLs/Hour
StandardPediatric
Scroll may be used to set infusion to maintenance, twice maintenance, etc
Scroll may be used to set infusion To Broselow-Luten color
Select BL System
Infusion pump windowTo be used in coordination with infusion label
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10 %
Broselow-Luten color Per Cent of maintenance Fluid requirements
Scroll barScroll bar
2
mLs/Hour
StandardPediatric
Scroll may be used to set infusion to maintenance, twice maintenance, etc
Scroll may be used to set infusion To Broselow-Luten color
Blue 2501-3000 GMS
Select BL System
Infusion pump windowTo be used in coordination with infusion label
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15%
Broselow-Luten color Per Cent of maintenance Fluid requirements
Scroll barScroll bar
1.5
mLs/Hour
StandardPediatric
Scroll may be used to set infusion to maintenance, twice maintenance, etc
Pink501-550 GMS
Scroll may be used to set infusion To Broselow-Luten color
Select BL System
Infusion pump windowTo be used in coordination with infusion label
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Computer Based
Computer Based Approach
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DRUG NAME
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DRUG NAME
Pancuronium
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PINK
RED
PURPLE
YELLOW
WHITE
BLUE
ORANGE
GREEN
Paralyzing
Defasiculation
Maintenance
1mg/mLconcentration
2mg/mLconcentration
COLOR INDICATION CONCENTRATION
Pancuronium
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PINK
RED
PURPLE
YELLOW
WHITE
BLUE
ORANGE
GREEN
Paralyzing
Defasiculation
Maintenance
1mg/mLconcentration
2mg/mLconcentration
COLOR INDICATION CONCENTRATION
Pancuronium
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PINK
RED
PURPLE
YELLOW
WHITE
BLUE
ORANGE
GREEN
Paralyzing
Defasiculation
Maintenance
1mg/mLconcentration
2mg/mLconcentration
COLOR INDICATION CONCENTRATION
Pancuronium
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PINK
RED
PURPLE
YELLOW
WHITE
BLUE
ORANGE
GREEN
Paralyzing
Defasiculation
Maintenance
1mg/mLconcentration
2mg/mLconcentration
COLOR INDICATION CONCENTRATION
Pancuronium
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PURPLE 2mg
Paralyzing
Defasiculation
Maintenance
Pancuronium
1mg/mLconcentration
2mL
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RED 1.7mL 1.7mg
Paralyzing
Defasiculation
Maintenance
Pancuronium
1mg/mLconcentration
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BLUE 4.2mL 4.2mg
Paralyzing
Defasiculation
Maintenance
Pancuronium
1mg/mLconcentration
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ORANGE 5.3mL 5.3mg
Paralyzing
Defasiculation
Maintenance
Pancuronium
mg/mLconcentration
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Setting a New Standard
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November 26, 2001 3:03:00 PM ET
CHICAGO--(BW HealthWire)--Nov. 26, 2001--
Color Coding for Kids to Provide Easy Reference Guidelines for Hospitals and Help Reduce CT Radiation for Children
GE Medical Systems, a unit of the General Electric Corporation (GE: NYSE), has signed an agreement that will allow GE to apply the Broselow-Luten Pediatric System, commonly known as Color Coding for Kids, to all of its medical imaging and patient information systems. The results of this agreement could positively impact millions of pediatric patients in the years to come.
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Jerome Medical
Addressing pediatric issues of airways management and spinal alignment
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P1 Collar (Ages 0-2 yrs.)
P2 Collar(Ages 2-6 yrs.)
P3 Collar(Ages 6-12 yrs.)
Adult(Ages > 12 yrs.)
Kids vs. AdultsOccipital Angle
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P1 Collar (Ages 0-2 yrs.)
P2 Collar(Ages 2-6 yrs.)
P3 Collar(Ages 6-12 yrs.)
Adult(Ages > 12 yrs.)
Kids vs. AdultsNeck Length
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Importance of Alignment:
Always raise the child's thorax with the appropriate height padding to accommodate the occipital prominence and to maintain c-spine alignment and open airway with or without collar.
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Potential for color-coding
Unit dosing and packaging of Pediatric drugs (associated cost savings)Defibrillator settingsInfusion PumpsRespiratorsComputer order entryCar Restraints
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Error Prevention for the Public
OTC Medications
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Color
“A Universal Language”
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