Pediatric Stridor

P605 Keep the patient calm Consider 0.9% NaCl mist via nebulizer Place patient on a cardiac monitor Contact medical control if considering nebulized epinephrine Epinephrine 0.5 ml of 1:1000 solution mixed in 2.5 ml of 0.9% NaCl, nebulized Continue nebulized 0.9% NaCl afterwards may be beneficial

Pediatric Respiratory Distress (Wheezing or Asthma)

P607 Assess need for assisted ventilation Allow patient to sit in a position of comfort If wheezing, albuterol 0.5 ml in 2.5 ml 0.9% NaCl nebulized Initiate transport May give 3 albuterol nebulized treatments. May considering adding 1 vial Ipratropium Bromide (0.5% of 0.02%) to the albuterol treatments, or substituting Duoneb.  Contact medical control if […]

Pediatric Respiratory Distress (Obstruction or FBO)

P606 Alert and not choking Begin transport with patient as comfortable as possible If wheezing, albuterol nebulized treatment Alert and choking <1 y.o., give 5 back slaps and 5 chest thrusts; repeat as necessary >1 y.o., give abdominal thrusts (Heimlich maneuver) Unconscious Begin CPR/BVM With laryngoscope, look for foreign body and remove with Magill forceps […]

Pediatric PVST

P604 Obtain 12 lead ECG If STABLE patient: Vagal maneuvers Contact medical control Adenosine 0.1 mg/kg IV rapid push (maximum first dose 6 mg); may repeat with dose doubled (maximum second dose 12 mg) Only on the conscious patient and the order of a medical control physician, administer midazolam 0.1 mg/kg (max 5 mg) IV/IO […]

Pediatric Bradycardia

P603 If symptomatic give oxygen, use BVM as needed, and recheck pulse rate If HR <60, BVM and chest compressions Epinephrine 1:10,000 IV/IO at 0.1 ml/kg or 1:1000 at 0.1 ml/kg via ETT (max dose 2 ml) Contact medical control Repeat epinephrine every 5 minutes After epinephrine, consider 1 dose of atropine, 0.02 mg/kg (min […]

Pediatric Pulseless VT/VF

P601 Defibrillate 2 J/kg (max 200 J) and resume CPR for two minutes; do not exceed adult dose Defibrillate 4 J/kg (max 360 J) and resume CPR; do not exceed adult dose Consider intubation Epinephrine 1:10,000 at 0.1 ml/kg IV/IO (preferred) or Epinephrine 1:1000 at 0.1 ml/kg ETT (max 2 ml); repeat Epinephrine every 3-5 […]

Pediatric Asystole / PEA

P602 After 2 minutes of CPR, check cardiac rhythm and pulse, then consider intubation Epinephrine 1:10,000 at 0.1 ml/kg IO/IV or Epinephrine 1:1000 at 0.1 ml/kg ETT (max dose 2 ml) Contact medical command 0.9% NaCl 20 ml/kg IV/IO Repeat epinephrine every 3-5 minutes

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 […]