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 additional treatments needed
  • For severe respiratory distress, contact medical control while BVM ventilating. For impending respiratory failure, contact medical control for consideration of epinephrine 1:1000 IM 0.01 ml/kg (max 0.3 ml)
  • For patients ages 3-16 y.o. who are awake, oriented, can take oral medications, have known asthma or reactive airway disease, or history of multiple episodes of wheezing responsive to albuterol, and are NOT currently taking steroids, have a history of cancer, diabetes, or immune deficiency, administer one of the following:

Prednisolone 3 mg/ml liquid

  • Age 3-7 years: 30 mg (10 ml)
  • Age 8-16 years: 60 mg (20 ml)

Prednisone 20 mg tablets

  • Age 3-7 years: 30 mg (1.5 tabs)
  • Age 8-16 years:  60 mg (3 tabs)

Solumedrol IV solution to be administered PO (125 mg/2ml)

  • Age 3-7 years: 30 mg (0.5 ml)
  • Age 8-16 years: 60 mg (1 ml)
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