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The Valley Hospital Emergency Services
Standing Orders / Communications Failure Orders
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8.41-8.15 Standing orders for pediatric croup
(a) The following standing orders are authorized in the event that a pediatric patient presents with
croup:
a. Assess and secure the airway;
b. Administer oxygen therapy as patient condition indicates;
c. Maintain normal body temperature and position of comfort;
d. Mild to moderate distress (barking cough, inspiratory stridor):
i.
Administer 3 cc normal saline via nebulizer with simple mask; and
ii.
Contact medical command;
e. Moderate to severe distress (stridor at rest, retractions, tripoding, and accessory muscle
use):
i.
Administer Epinephrine 3 mg (3 cc) 1:1,000 solution via nebulizer;
ii.
If no change, establish IV/IO access with normal saline at a KVO rate; and
iii.
Contact medical command.
Communications Failure Orders pediatric croup
(a) If during the course of transport, patient requires intubation, refer to the Standing Orders and
Communications Failure Orders for pediatric advanced airway.
(b) Administer Dexamethasone 0.7 mg/kg to a maximum of 10 mg via vascular access.