Respiratory distress severity score RDSS

Respiratory distress severity score RDSS

total score 0-4 = mild; 5-7= moderate; >8 severe

score	Respiratory Rate	RR	wheezing	aeration	retractions
	0-1yr	1-2yr
0	20-40	15-30	none	all fields	none
1	41-55	31-45	Mild exp	4 or more fields	mild
2	>55	>45	insp and exp	<4 fields	marked

Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and
KEM HOSPITAL MUMBAI INDIA

Respiratory distress severity score RDSS

FLUID DISTRIBUTION per kg body weight

Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and
KEM HOSPITAL MUMBAI INDIA



Neonate Child Adult

Total water 750 ml/kg 650 ml/kg 550 ml/kg

Intracellular 350 ml/kg 350 ml/kg 300 ml/kg
water

Extracellular 400 ml/kg 300 ml/kg 250 ml/kg
water

Whole blood 90 ml/kg 80 ml/kg 75 ml/kg

Plasma 40 ml/kg 35 ml/kg 35 ml/kg

MAINTENANCE Fluid REQUIREMENTS in children

MAINTENANCE Fluid REQUIREMENTS in children
IV fluid: 4.3% dextrose in 0.18% saline.
Add to each litre: 1g (13 mEq) of potassium chloride (and 1 ampoule - 2 ml - of Intravite if IV
maintenance and nil by mouth is to be continued for more than 3 days).
Amount:
0-10 kg: 100 ml/kg/day
4 ml/kg/hr

11-20 kg: 1000 ml + 50 ml/kg/day for each kg above 10 kg
40 ml + 2 ml/kg/hr

Above 20 kg: 1500 ml + 20 ml/kg/day for each kg above 20 kg
60 ml + 1 ml/kg/hr

all fits as per Holiday and Segar's formula



Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and KEM HOSPITAL MUMBAI INDIA

Weech's formula weight height estimates

weight	in Kg	in Pounds
at birth	3.25	7
3-12 mo	[age(month)plus9] by 2	age (mo) plus 11
1-6 yr	[age(yr)2]+8	[age(yr)5]+17
7-12 yr	[7x-5]/2	7x-5
height	cm	inches
at birth	50	20
1 yr	75	30
2-12 yr	6x+77	2x+30

Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and
KEM HOSPITAL MUMBAI INDIA

Tanner staging sexual maturity score

Pubic hair (both male and female)

1. Tanner I -- no pubic hair at all [10 and under] (prepubertal state)
2. Tanner II -- small amount of long, downy hair with slight pigmentation at the base of the penis and scrotum (males) or on the labia majora [10-11](female)
3. Tanner III -- hair becomes more coarse and curly, and begins to extend laterally [12-14]
4. Tanner IV -- adult-like hair quality, extending across pubis but sparing medial thighs [13-15]
5. Tanner V -- hair extends to medial surface of the thighs [16+]

Genitals (male)

1. Tanner I -- prepubertal (testicular volume less than 1.5 ml; small penis of 3 cm or less)
2. Tanner II -- testicular volume between 1.6 and 6 ml; skin on scrotum thins, reddens and enlarges; penis length unchanged
3. Tanner III -- testicular volume between 6 and 12 ml; scrotum enlarges further; penis begins to lengthen to about 6 cm
4. Tanner IV -- testicular volume between 12 and 20 ml; scrotum enlarges further and darkens; penis increases in length to 10cm and circumference
5. Tanner V -- testicular volume greater than 20 ml; adult scrotum and penis of 15 cm in length

Breasts (female)

1. Tanner I -- no glandular tissue; areola follows the skin contours of the chest (prepubertal)
2. Tanner II -- breast bud forms, with small area of surrounding glandular tissue; areola begins to widen
3. Tanner III -- breast begins to become more elevated, and extends beyond the borders of the areola, which continues to widen but remains in contour with surrounding breast
4. Tanner IV -- increased breast size and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast
5. Tanner V -- breast reaches final adult size; areola returns to contour of the surrounding breast, with a projecting central papilla.

clinical manifestations of childhood tuberculosis

how to measure palpable spleen length or spleenomegaly?

Measuring length of spleen has been confusing medical students since years, many examiners giving subjective opinions and guidelines that may not serve purpose all the time. the misunderstanding which is taught most often is that spleen is to be measured as a perpendicular length from tip to costal margin or at midclavicular line. but that is wrong.

The correct way to measure palpable spleen length is the length from the tip of the spleen along the long axis, at the midpoint of green line C, the line that joins the points c1 and c2, that are the points where spleen gets retrocostal. Refer the image on right side, there are 3 spleens A B C. The yellow lines drawn give correct measurements of respective spleens even though the lines are not perpendicular to costal margin nor they are ending in midclavicular line.

Spleen length may be falsely small at times if perpendicular length or length upto midclavicular line on costal margin is taken, Just because the apex of spleen doesnt always lie along the line towards umbilicus and umbilicus doesnt always lie in center.

learning basics of pediatric medicine

learning basics of pediatric medicine

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