Prehospital protocol pediatric anaphylaxis: Difference between revisions
Ostermayer (talk | contribs) |
Neil.m.young (talk | contribs) (Text replacement - "* " to "*") |
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| Line 10: | Line 10: | ||
*IF (weight <25) | *IF (weight <25) | ||
**Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) | **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 auto injector is not available, give epinephrine 1:1000 (weight *0.01) mg IM | ||
*IF (weight > 25) | *IF (weight > 25) | ||
**Give EpiPen IM (0.3mg epinephrine 1:1000 IM) | **Give EpiPen IM (0.3mg epinephrine 1:1000 IM) | ||
**If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg IM | **If autoinjector is not available, give epinephrine (1:1000) (weight *0.01) mg IM | ||
===No=== | ===No=== | ||
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====Yes==== | ====Yes==== | ||
*IF (weight <25) kg | *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 | **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 | *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 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== | ==IV NS TKO, Cardiac Monitor, Pulse Oximetry== | ||
| Line 41: | Line 41: | ||
==Hypotension or Poor Perfusion?== | ==Hypotension or Poor Perfusion?== | ||
===Yes=== | ===Yes=== | ||
#Give (weight * 20) mL/kg NS bolus and reassess. | #Give (weight *20) mL/kg NS bolus and reassess. | ||
#Repeat bolus x 3 times if continued signs of poor perfusion | #Repeat bolus x 3 times if continued signs of poor perfusion | ||
| Line 47: | Line 47: | ||
If patient has continued signs of anaphylaxis and no epinephrine was given in the last 5 minutes then | If patient has continued signs of anaphylaxis and no epinephrine was given in the last 5 minutes then | ||
*IF (weight < 25) kg | *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 | **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 | *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 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 1 mg/kg IV/IM== | ==Give Diphenhydramine 1 mg/kg IV/IM== | ||
Revision as of 13:44, 4 July 2016
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
- Assess for signs of poor perfusion.
- If hypotension, and pulmonary edema administer 10cc/kg NS IV
- If hypotension and NO pulmonary edema administer 20cc/kg NS IV
- Follow Non-Traumatic Shock protocol (8.03 CC)
Wheezing or Shortness of Breath?
- 2.5mg/3mL Albuterol 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 1 mg/kg IV/IM
- Max dose 50mg
Notify Receiving Hospital
- Continue transport, and frequent reassessments
- Contact online medical control if in need of further instructions