ValleyProtocolBook

The Valley Hospital Emergency Services

17

Standing Orders / Communications Failure Orders

8.41-8.12 Standing orders for pediatric asthma

(a) The following standing orders are authorized in the event that a pediatric patient presents with asthma:

a. Assess and secure airway; administer oxygen as needed, or via nebulizer;

b. Maintain normal body temperature;

c. Mix 2.5 mg Albuterol and Ipratropium Bromide 0.5 mg into normal saline and administer via nebulizer;

d. Reassess patient and if patient condition requires administer a maximum of two additional treatments of 2.5 mg Albuterol/3 mL normal saline solution via nebulizer;

e. If patient condition becomes more unstable:

i. Administer Epinephrine 0.01 mg/kg (0.01mL/kg) of a 1:1,000 solution to a maximum of 0.5 mg via SC route;

ii. Establish vascular access of normal saline solution at a KVO rate;

f. Contact medical command.

Communications Failure Orders for pediatric asthma

(a) Administer continuous Albuterol 2.5 mg treatments via nebulizer.

(b) Administer Methylprednisolone Sodium Succinate 2 mg/kg up to 125 mg

(c) Administer Ipratropium Bromide 0.5 mg / 2.5 mL normal saline via nebulizer.

(d) If patient continues to show signs of significant distress;

a. Administer Magnesium 25 mg/kg up to one (1) gram via vascular access; and

b. Administer Normal Saline 20 mL/kg via vascular access

(e) Consider intubation for patients who fail to respond to initial therapy. Refer to the Standing Orders and Communications Failure Orders for pediatric advanced airway.