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 […]

Nausea / Vomiting

M405 Contraindicated for allergies to 5-HT(3) receptors such as Kytril and Aloxi Administer ondansetron (Zofran) IV/IO 4mg slow IV push, OR Administer ondansetron (Zofran) IM/PO 4mg (PO=solutab) Repeat 4mg IV/IO dose in 5 minutes if symptoms have not resolved

Hypothermia

M412 Remove from cold environment, and remove wet clothing Insulate with dry, warm covering Initiate IV/IO access and administer 1 liter saline Monitor cardiac rhythm Dextrose 50% 25g IV if Glucose < 70 Narcan 0.4 to 2mg IV if suspect narcotic OD Follow CPR protocol when appropriate Transport to hospital capable of cardiopulmonary bypass

Hyperthermia

M413 Remove clothing Ice packs to axilla, groin, & neck Avoid cooling so much that patient begins to shiver; this will cause body temperature to increase Cardiac monitor If patient appears dehydrated, IV 500-1000 ml saline bolus or 20 ml/kg for children