Pediatric emergency medicine trisk 3051 3051
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thiosulfate (2.5–5 mL/min of 25% solution) IV over
10–30 min, or IV push in cardiac arrest
Children: (Na nitrite should not exceed recommended
dose because dangerous methemoglobinemia may
result):
Hemoglobin
Initial dose 3% Initial dose 25%
Na nitrite
Na thiosulfate
IV (mL/kg)
8g
0.22 mL/kg (6.6
mg/kg)
0.27 mL/kg (8.7
mg/kg)
0.33 mL/kg (10
mg/kg)
10 g
12 g (normal)
14 g
Cyanide—
hydroxocobalamin
(preferred)
Digitalis
Fluoride
Heavy metals
1.10
1.35
1.65
0.39 mL/kg (11.6 1.95
mg/kg)
Adult : 5 g IV; Child: 70 mg/kg IV over 30 min or IV
push in cardiac arrest
Fab antibodies (Digibind): Dose based on amount
ingested and/or digoxin level (see text, package
insert)
Calcium gluconate 10%, 0.6 mL/kg IV slowly until
symptoms abate, serum calcium normalizes; repeat
PRN while monitoring serum calcium
BAL (British Anti-Lewisite; dimercaprol): 300–450
mg/m2 /day (18–24 mg/kg/day) deep IM in 6 divided
doses for 3–5 days a (Arsenic, Mercury, Lead )
CaNa 2EDTA (ethylenediaminetetraacetic acid):
1,000–1,500 mg/m2 /day (25–75 mg/kg/day)
continuous IV infusion or in 2–4 divided doses for
up to 5 days; see text for further details (Lead )
DMSA (succimer): 350 mg/m2 (10 mg/kg) PO every 8
hrs for 5 days, followed by 350 mg/m2 (10 mg/kg)
