Maine:Prehospital protocol pediatric wheezing (2 yo & greater)

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Airway Assessment

  • Assess for respiratory distress
  • Monitor for apnea

Albuterol Administration

Contact OLMC

  • If patient has home albuterol assist them in administering 5 puffs of own rescue inhaler
  • If uncertainty regarding the type of inhaler, contact OLMC for permission
  • If nebulizer on scene then administer 2.5mg by nebulization (use 3 ml premix or 0.5 ml of 0.5% solution mixed in 2.5 ml of

normal saline)

Critical Care actions

  • Albuterol 2.5mg by nebulization (2 times max)
  • Ipratropium bromide 0.5mg /albuterol sulfate 3mg nebulizer if greater than 1 year of age and more significant respiratory distress (2 times max)

Epinephrine

Contact OLMC prior to administration

  • If < 30 kg, 0.15mg IM (0.15 ml of 1:1,000)
  • If > 30 kg, 0.3mg IM (0.3 ml of 1:1,000) in anterolateral thigh OR
  • Inhalation of nebulized solution of 1ml of 1:1,000 epinephrine mixed with 2ml of normal saline solution.