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