Breathing Difficulty – PED

BREATH PEDIATRIC RESPIRATORY DISTRESS (OBSTRUCTION or FBO) PEDIATRIC RESPIRATORY DISTRESS (WHEEZING or ASTHMA) PEDIATRIC STRIDOR

Newborn Resuscitation

P600 Suction mouth, then nose Dry infant, keep warm BVM rate of 60 breaths/min for HR <100 Apply pulse oximeter to determine oxygen requirement Chest compressions for HR <60, 3:1 ratio with breaths, 120 events/minute After 30 seconds of BVM ventilation, consider intubation (PREMATURE=2.5-3.0 ETT; FULL TERM=3.0-3.5 ETT) Contact medical control After 30 seconds of […]

Anaphylaxis – PED

P609 Remove exposure to allergen For respiratory symptoms or hypotension, epinephrine 1:1000 IM 0.01 ml/kg (max 0.3 ml) AND give 20 ml/kg 0.9% NaCl IV (max 1 L) May repeat epinephrine 1:1000 every 5 – 15 mins as needed If bronchospasm or wheezing, give albuterol nebulizer tx 0.5 ml in 2.5 ml 0.9% NaCl Medical […]

Toxicological Emergency

Altered Mental Status – PED P611 If narcotic overdose, naloxone 0.1 mg/kg IV/IM/IN/IO (max 2 mg) If toxin remains on patient, wash or brush off as appropriate. Alert medical control if patient will require further decontamination; patient NOT to be brought through regular Triage. For eye exposure, flush the eyes with 0.9% NaCl for at […]

Pediatric Seizure

Altered Mental Status – PED P610 100% O2 or BVM ventilate if needed Consider nasopharyngeal airway Seizing >5 min, give Midazolam ≤12 kg = 0.2 mg/kg IV/IO/IM/IN 13-40 kg = 5 mg IV/IO/IM/IN Contact medical control for seizing >15 min

Pediatric Diabetic Reaction

Altered Mental Status – PED P608 IF blood glucose is < 70 mg/dl: If dysrhythmia present, proceed to appropriate protocol For shock, push 20 ml/kg 0.9%NaCl IV/IO (max 1 L) If glucose ≤70, administer 1 ml/kg D50W IV/IO push; If child ≤3 y.o. or ≤ 15 kg, instead push 2 ml/kg of D25 IV/IO (D25 […]

Pain Management

S505 Systolic BP >100 mmHg, no head injury or altered level of consciousness Fentanyl 25-100mcg IV/IM/IN/IO or Morphine Sulfate 1-5mg IV/IM/IO Repeat once if pain is not relieved in 5 min and BP >100 systolic Monitor BP, respirations, and mental status Narcan 0.4-2.0mg IV/IM/IN/IO if patient experiences respiratory depression

Obstetrical (Child Birth)

S503 >24 weeks = viable baby O2 & IV if time permits Assist with delivery if head is presenting Elevate hips and transport if delivery is malpresentation Prolapsed cord = relieve pressure on cord, elevate hips, keep cord moist, transport Cord around neck = gently slip over head; if too tight, apply 2 clamps 1 […]