554 PEDIATRIC ASTHMA

In pediatric patients with acute asthma and/or active wheezing:

1. Begin Basic Life Support Pediatric Respiratory Distress/Failure procedures.

2. In patients one (1) year of age or older with severe respiratory distress, respiratory failure, and/or decreased breath sounds, administer Epinephrine 0.01 mg/kg (0.01 ml/kg of a 1:1,000 solution), subcutaneously. (Maximum dose is 0.3 ml.) (See Appendix J.)

   During transport, or if transport is delayed:

3. Administer Metaproterenol 5% (0.3 ml in 2.5-5.0 ml of 0.9% saline solution)

   OR

   Albuterol Sulfate 0.083% (one unit dose bottle of 3.0 ml), by nebulizer, in patients six (6) years of age or older. Use half the amount of each drug in patients less than six (6) years of age. (See Appendix J.)

4. If the patient develops or remains in severe respiratory distress or respiratory failure, contact Medical Control for implementation of one or more of the following options:

MEDICAL CONTROL OPTIONS

OPTION A:

Repeat Epinephrine 0.01 mg/kg (0.01 ml/kg of a 1:1,000 solution), subcutaneously, 20 minutes after the first dose. (See Appendix J.)

OPTION B:

Repeat Metaproterenol 5% (0.3 ml in 2.5-5.0 ml of 0.9% saline solution) OR Albuterol Sulfate 0.083% (one unit dose bottle of 3.0 ml), by nebulizer, in patients six (6) years of age or older. Use half the amount of each drug in patients less than six (6) years of age. (See Appendix J.)

OPTION C:

Begin an IV infusion of Ringer's Lactate (RL), to keep vein open. Attempt IV only once.

OPTION D:

Transportation decision.