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Drug Dosing: Infants and Children

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...

Tertiary Healthcare System

Tertiary Healthcare System

Specialized care provided over an extended period is called tertiary care. Usually, a primary or secondary care physician will refer a patient to tertiary care. A patient's maximum physical and mental function is restored in tertiary care, which is caused due to the impact of a chronic illness or condition. Tertiary care aims to achieve the highest level of functioning possible while managing chronic illness. For example, a patient who falls and fractures their hip will need secondary care...

Pharmacokinetics in Pediatric Patients: Drug Excretion

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...

Pharmacokinetics in Pediatric Patients: Drug Distribution

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...

Pharmacokinetics in Pediatric Patients: Drug Metabolism

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...

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Related Experiment Video

Updated: Apr 15, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Pediatric Disposition Classification (Reverse Triage) System to Create Surge Capacity.

Gabor D Kelen¹, Lauren Sauer¹, Eben Clattenburg¹

¹The Department of Emergency Medicine,The Johns Hopkins University School of Medicine,Baltimore,Maryland.

Disaster Medicine and Public Health Preparedness

|March 28, 2015

Summary

This summary is machine-generated.

Pediatric reverse triage systems can be developed using a risk-based classification for early patient discharge during surge events. This approach helps manage hospital capacity by identifying patients safe for early discharge.

Keywords:

disaster planning health care rationing hospital bed capacity risk assessment surge capacity

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Area of Science:

Pediatric critical care
Disaster medicine
Health systems management

Background:

Pediatric hospital capacity is often insufficient during emergencies.
Existing adult reverse triage systems are not explored in pediatrics.
Developing pediatric surge capacity is crucial for disaster preparedness.

Framework:

A 5-category risk-based disposition classification system for pediatric inpatients was developed.
The system is based on risk tolerance for consequential medical events (CME).
Expert consensus was achieved through a modified-Delphi process.

Implementation:

Twenty-five critical interventions (CIs) were identified and ranked by CME risk.
The likelihood of CME if CIs were withdrawn or withheld was assessed.
Panelists established upper limit CME risk percentages for each disposition category.

Implications:

The classification system provides a framework for ethically acceptable pediatric reverse triage.
It aids in identifying pediatric patients suitable for early discharge during surge events.
This research supports enhanced disaster preparedness in pediatric healthcare.