ValleyProtocolBook

The Valley Hospital Emergency Services

21

Standing Orders / Communications Failure Orders

8.41-8.16 Standing orders for pediatric non-traumatic shock

(a) The following standing orders are authorized in the event that a pediatric patient presents with non-traumatic shock:

a. Assess and secure the airway;

b. Administer oxygen therapy as patient condition indicates;

c. Maintain normal body temperature;

d. Establish vascular access with normal saline solution at a KVO rate;

e. Administer a rapid fluid bolus of normal saline at a dose of 20 mL/kg;

f. Obtain a rapid glucose test. If blood glucose is less than 60:

i. For patients less than one month of age, administer 0.5 g/kg of a 10 percent dextrose solution via IV/IO;

ii. For patients greater than one month of age, administer 0.5 g/kg of a 25 percent dextrose solution via IV/IO.

iii. If unable to establish vascular access, administer Glucagon 0.1 mg/kg (0.1 ml/kg) to a maximum of 1 mg IM (1mg=1ml=1 unit);

g. If no change, administer a rapid fluid bolus of normal saline solution at a dose of 20 mL/kg; and

h. Contact medical command.

Communications Failure Orders pediatric non-traumatic shock

(a) If the patient has not improved, administer a rapid fluid bolus of normal saline at a dose of 20 mL/kg.

(b) If during the course of transport, patient requires intubation, refer to the Standing Orders and Communications Failure Orders for pediatric advanced airway.