Prehospital protocol pediatric anaphylaxis: Difference between revisions
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== | ==Perform general assessment== | ||
#100% O2 NRB | #100% O2 NRB | ||
#Check Vital Signs | #Check Vital Signs | ||
#Assist Ventilations with <span style="color:# | #Assist Ventilations with <span style="color:#add8e6"> BVM</span> as needed | ||
==Signs Symptoms of Anapylaxis?== | ==Signs Symptoms of Anapylaxis?== | ||
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#Throat tightness or facial/lip/tongue swelling | #Throat tightness or facial/lip/tongue swelling | ||
#Widespread hives, itching, swelling | #Widespread hives, itching, swelling | ||
#Persistent | #Persistent vomiting or abdominal pain | ||
#AMS, syncope, or decreased consciousness | #AMS, syncope, or decreased consciousness | ||
====Yes==== | ====Yes==== | ||
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==Give Diphenhydramine (weight * 1.0) mg IV/IM== | ==Give Diphenhydramine (weight * 1.0) mg IV/IM== | ||
==Notify | ==Notify Receiving Hospital== | ||
#Continue transport, and frequent reassessments | #Continue transport, and frequent reassessments | ||
#Contact online medical control if in need of further instructions | #Contact online medical control if in need of further instructions | ||
[[Category:EMS]] | [[Category:EMS]] | ||
Revision as of 00:20, 30 September 2015
Perform general assessment
- 100% O2 NRB
- Check Vital Signs
- Assist Ventilations with BVM as needed
Signs Symptoms of Anapylaxis?
Is there a known allergen exposure with hypotension or respiratory distress?
Yes
- IF (weight <25)
- Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM)
- If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM
- IF (weight > 25)
- Give EpiPen IM (0.3mg epinephrine 1:1000 IM)
- If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg IM
No
Acute onset of symptoms and 2 or more of the following?
- Hypotension, cyanosis, delayed cap refill
- Dyspnea, wheezing, stridor, or respiratory distress
- Throat tightness or facial/lip/tongue swelling
- Widespread hives, itching, swelling
- Persistent vomiting or abdominal pain
- AMS, syncope, or decreased consciousness
Yes
- IF (weight <25) kg
- Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg/kg IM
- IF (weight > 25) kg
- Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg/kg IM
IV NS TKO, Cardiac Monitor, Pulse Oximetry
Wheezing or Shortness of Breath?
- 2.5mg/3mL NS via Nebulizer may be administered
- Repeat as needed
Hypotension or Poor Perfusion?
Yes
- Give (weight * 20) mL/kg NS bolus and reassess.
- Repeat bolus x 3 times if continued signs of poor perfusion
Recurrent signs of Anaphylaxis?
If patient has continued signs of anaphylaxis and no epinephrine was given in the last 5 minutes then
- IF (weight < 25) kg
- Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM
- IF (weight > 25) kg
- Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg/kg IM
Give Diphenhydramine (weight * 1.0) mg IV/IM
Notify Receiving Hospital
- Continue transport, and frequent reassessments
- Contact online medical control if in need of further instructions