47 / 70
The Valley Hospital Emergency Services
Standing Orders / Communications Failure Orders
17
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.