Pediatric Community

  • 1.  Drawing up Code Meds- Pedi Hospitals

    Posted 09-12-2025 12:24 PM

    Hello, 

    Who draws up meds during resuscitations at pediatric hospitals? Do you have pharmacy at the bedside or are the nurses responsible? If you are using nurses, do you provide resources for weight-based dosing (beside Braslow)? Thanks for your help. 

    Natalie 



    ------------------------------
    Natalie Pham MSN, RN, CPEN, CPN
    Education Coordinator
    Texas Children's Hospital
    Houston, Texas
    832-824-5443
    ------------------------------


  • 2.  RE: Drawing up Code Meds- Pedi Hospitals

    Posted 09-13-2025 09:56 AM

    Hello,

    We do call pharmacy, and they pull up meds but until they arrive the nurses are responsible for pulling meds. Pharmacy developed code sheets that have dosing on them. One code sheet for every kg 1-50. They might go by 2s after 20kg. So like 20,22,24,26...All of these are in a binder on top of our code cart. 

    I know some people use the app PediStat. 

    I hope this helps.



    ------------------------------
    Becca Mielke, MSN, RN, CPEN, TCRN

    RN Practice Specialist
    Emergency Department
    Dell Children's Medical Center
    ------------------------------

    Original Message


  • 3.  RE: Drawing up Code Meds- Pedi Hospitals

    Posted 09-14-2025 05:07 PM
    At the two pediatric hospitals in our healthcare network, a pharmacist will respond if there is one available to come. However, the nurses are responsible for pulling up medications. The exception is in one hospital nurses must have pharmacy mix drips. One of the hospitals uses forms that are filled in on admission with weights and dosages of meds for each pediatric patient and placed at bedside on their whiteboards. Both use the Handtevy system for pediatric codes, which includes color-coded books with dosages for emergency medications by weight and age as well as an app that can be pulled up on a phone or iPad. The iPads stay by the crash carts. The advantage in using the app is that it records all meds, equipment, electrical, initiation of chest compressions, intubation, etc. in real time. At the end of the code, a summary is available with times and all information for documentation. We require our pediatric nurses to attend an annual code class that includes hands on practice in finding dosages and pulling up medications.



    Original Message


  • 4.  RE: Drawing up Code Meds- Pedi Hospitals

    Posted 10-09-2025 11:49 AM

    My experience is at a hospital with a lot of resources for this, so my answer may not be in alignment with what's possible at your facility.  We have a 24/7 pharmacy team dedicated to the ED and they prioritize responding to codes and traumas to assist with medications (confirming orders, drawing up medications, diluting, reconstituting, and also retrieving medications that we may not stock in the code or trauma rooms).  The nurses are trained on that role as well and there is always a nurse assigned as a medication nurse even though they may not be needed is a pharmacist is available.  We have a printed book that has weight ranges.  Pharmacy develops and maintains this binder.  All the medications are calculated for the average weight in the weight range using the concentrations we stock so the end volume is provided as well as any administration guidance such as time of administration or further dilution.  It is a lot of work to maintain and update this reference, but it decreases medication errors significantly when the nurse is not calculating dosages and volumes in real time.



    ------------------------------
    Emily Dorosz MSN;RN;CPEN;CPN
    Maryland State Council
    ------------------------------

    Original Message


  • 5.  RE: Drawing up Code Meds- Pedi Hospitals

    Posted 09-30-2025 04:07 PM

    Hello,
    Similar to Becca at our facility if there is a PharmD available they will respond to a code, but until they are available, or if they are unavailable an RN is responsible for drawing up medications.

    Our electronic health record allows us to print a "code med" sheet once a patient's dosing weight has been entered, and it's standard practice to print one of these and post it in each patient's room so in the event of a code the person pulling medication doesn't have to do math, but can refer to the code sheet.

    Hope that helps. 



    ------------------------------
    Elizabeth Leming BSN;BA;CCRN
    Clinical Practice Specialist
    Children's Minnesota
    St Paul MN
    ------------------------------

    Original Message


  • 6.  RE: Drawing up Code Meds- Pedi Hospitals

    Posted 10-16-2025 12:50 PM

    Elizabeth, what EMR are you using and is this something only done for Peds?



    ------------------------------
    Steven P. Rogers, RN CEN
    Pediatric Emergency Care Coordinator
    Olive View UCLA Medical Center
    Sylmar, CA
    strogers@dhs.lacounty.gov
    ------------------------------

    Original Message


  • 7.  RE: Drawing up Code Meds- Pedi Hospitals

    Posted 5 days ago

    This is our policy as well - but with the safety caveat that the dosings are only correct if the weight is entered correctly, so we do double checks on all weights being entered in our EMR and only weigh in kg.



    ------------------------------
    Tara Doherty, MSN, RN, CPEN, TCRN
    Pediatric Emergency Nurse
    NewYork-Presbyterian/Morgan Stanley Children's Hospital
    New York, NY
    ------------------------------

    Original Message


  • 8.  RE: Drawing up Code Meds- Pedi Hospitals

    Posted 29 days ago

    We have pharmacy except for 11p-7a in our pedi ED. They draw up meds. We have handtevy available as an app for all staff and a code book with weight based pages and resuscitation meds that are in dose and volume per hospital stock. 



    ------------------------------
    Ann Kach MSN, RN CEN, CPEN
    Nurse Education Safety Specialist
    ------------------------------

    Original Message