Question: A 6-year-old child presents for emergency appendicectomie. How can you estimate the weight of the child?

Answer: A commonly used formula to estimate weight in children is:

• Weight (kg) = (age in years + 4) x 2
• Therefore, weight (kg) = (6 + 4) x 2 = 20 kg

Select the Thiopentone tab to continue.

Question: A 6 yr old child presents for emergency appendicectomie. How can you estimate the weight of the child?

Answer: A commonly used formula to estimate weight in children is:

• Weight (kg) = (age in years + 4) x 2
• Therefore, weight (kg) = (6 + 4) x 2 = 20 kg

Question: What would be the induction dose of thiopentone for this child?

Answer: The induction dose of thiopentone for a child is 5 – 6 mg/kg

20 x 5 = 100mg

Click on the Thiopentone tab.

Question: What would be the induction dose of thiopentone for this child?

Answer: The induction dose of thiopentone for a child is 5-6 mg/kg. 20 x 5 = 100 mg.

Question: You are given the vial shown in Fig 1. How would you prepare 100 mg for this 6-year-old?

Answer

Question: What would be the induction dose of thiopentone for this child?

Answer: The induction dose of thiopentone for a child is 5-6 mg/kg. 20 x 5 = 100 mg.

Question: You are given the vial shown in Fig 1. How would you prepare 100 mg for this 6-year-old?

Answer: Fig 1 shows thiopentone sodium 500 mg powder. Dilute 500 mg in 20 ml of sterile water to obtain 25 mg/ml (2.5%). You would give the child 4 ml of this solution.

Vials with 1 gram of thiopentone need to be diluted with 40 ml of sterile water to get a 2.5% solution.

Select the ETT tab to continue.

Question: What size ETT would you choose for this 6-year-old 20 kg child?

Answer: A commonly used formula to estimate ETT size in children is:

• ETT size = age/4 + 4.5 mm
• ETT size = 6/4 + 4.5 mm = 6 mm

You would aim to use a size 6 ETT in this child with a bigger and a smaller ETT size available.

Select the Muscle relaxant tab to continue.

Question: Which muscle relaxant is appropriate and how much would you use?

Answer: An appendicectomie usually requires a rapid sequence induction using suxamethonium.

The dose for suxamethonium in children is 1-2 mg/kg.

This 6-year-old child with an estimated weight of 20 kg would need 20-40 mg.

Select the Anaphylaxis tab to continue.

Question: You have intubated the 6-year-old 20 kg child after giving thiopentone and suxamethonium. You find it difficult to ventilate, there is a rash and the blood pressure is very low. You suspect an anaphylactic reaction. What drug and how much would you give?

Answer: You would give adrenaline in anaphylaxis. A 6-year-old child would require either 300 mcg IM (0.3ml of 1:1000) or, based on weight, 1 mcg/kg IV = 20 mcg = 0.2 ml of 1:10 000

Select the Lignocaine tab to continue.

Question: The 6-year-old 20 kg child recovers well after you have given the adrenaline. You ask the surgeon to infiltrate the wound with 1% lignocaine. The surgeon asks you how many mls you would like him to give.

Answer: The dose of lignocaine is 3 mg/kg. You can give up to 60 mg in a 20 kg child. Lignocaine 1% contains 10 mg/ml; 60/10 = 6.

The surgeon can use 6 ml of 1% Lignocaine for infiltration.