Logistical Issues in Caring for the Small Adult. By Dr. Lars Peterson

  • Intensivists will occasionally care for adults whose weight is significantly less than an average patient; management isn’t always the same.

  • Adult intensivists will occasionally care for adults whose body weight is significantly less than an average adult patient (e.g., patients with developmental disorders, metabolic disorders, or connective tissue genetic mutations which affect growth)
  • When treating patients with these issues, consider:
    • Dosing medications by body weight rather than “standard” adult dosing, especially when less than 40kg and pre-planning the doses of important resuscitation medications ahead of time (e.g., meds for airway management, hemodynamic support, cardiac resuscitation, blood products, and fluids). Consider pre-printing these meds and doses and distributing them to the physicians and nurses caring for the patient.
    • Having pediatric code carts near the patient’s bedside because these are typically organized by body weight.
    • Stocking equipment for procedures that are appropriate for the patient’s size (e.g., central venous catheters, bag valve masks, laryngoscope blades, endotracheal tubes, blood pressure cuffs); the pediatric intensive care unit or the emergency department may be able to help obtain them if not immediately available.
    • If available, consider consulting a pediatric intensivist or with a specialty pediatric hospital to review the case. These patients may still follow with their pediatrician and consultation can help optimize the patient’s inpatient course.


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