Regional Emergency Medical Advisory Committee of New York City
Certified First Responder Support Protocols
Copyright January 1996 (8/96)

350 PEDIATRIC RESPIRATORY DISTRESS/FAILURE

NOTE:RESPIRATORY DISTRESS IN A CHILD IS CHARACTERIZED BY INCREASED RESPIRATORY EFFORT WITHOUT CENTRAL CYANOSIS, I.E., ANXIETY AND/OR RAPID BREATHING.

RESPIRATORY FAILURE IN A CHILD IS CHARACTERIZED BY INEFFECTIVE RESPIRATORY EFFORT WITH CENTRAL CYANOSIS, I.E., SLUGGISHNESS OR AGITATION, AND/OR LABORED BREATHING.

HEART RATE LESS THAN 100 BEATS PER MINUTE (BRADYCARDIA) IS AN OMINOUS SIGN THAT INDICATES HYPOXIC CARDIAC ARREST MAY BE IMMINENT.

Monitor the airway.

If an obstructed airway is suspected, see Protocol #351.

IF RESPIRATORY DISTRESS IS PRESENT:

Administer oxygen and allow patient to maintain a comfortable, upright position.

NOTE:

HIGH CONCENTRATION OXYGEN SHOULD ALWAYS BE USED IN PEDIATRIC PATIENTS.

DO NOT ALLOW THE MASK TO PRESS AGAINST THE EYES.

IF RESPIRATORY FAILURE IS PRESENT:

Assist ventilations at a rate of 20 breaths per minute.

NOTE:

DO NOT USE A DEMAND VALVE RESUSCITATOR DUE TO THE POSSIBILITY OF CAUSING SEVERE LIFE THREATENING COMPLICATIONS.


NOTE:

CHEST RISE IS THE BEST INDICATION OF ADEQUATE VENTILATION IN THE PEDIATRIC PATIENT.


Request Advanced Life Support assistance.

Monitor breathing for adequacy.

Transport in accordance with first response agency policy, keeping the child warm.



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