Pediatrics Report Sheet

Weight-based peds handoff, front and back

Two-patient pediatric handoff sheet. The back page is a full peds workstation: kilogram dosing with 4-2-1 maintenance fluids, a two-RN high-alert medication double check, age-based vital sign ranges from neonate to adolescent, code and Broselow quick reference, hourly intake, output and feeds with diaper weights and shift totals, FLACC / Wong-Baker / NIPS pain scoring, PEWS escalation, lines, tubes and drains, plus family, safety and developmental care checks.

• Weight-based dosing and 4-2-1 maintenance fluids
• Two-RN high-alert medication double check
• Age-based vital sign ranges (neonate to adolescent)
• Code, ETT, epi and Broselow quick reference
• Hourly I&O with feeds, diaper weights and totals
• FLACC / Wong-Baker / NIPS pain and comfort scoring
• PEWS escalation and lines, tubes and drains tracker
• Family, safety and developmental care section

• Instant PDF download after checkout
• Print at home on US Letter, front & back
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