Maine:Prehospital protocol pediatric wheezing (2 yo & greater)

Airway Assessment

• Assess for respiratory distress
• Monitor for apnea

Albuterol Administration

Contact OLMC

• If patient has home albuterol assist them in administering 5 puffs of own rescue inhaler
• If uncertainty regarding the type of inhaler, contact OLMC for permission
• If nebulizer on scene then administer 2.5mg by nebulization (use 3 ml premix or 0.5 ml of 0.5% solution mixed in 2.5 ml of

normal saline)

Critical Care actions

• Albuterol 2.5mg by nebulization (2 times max)
• Ipratropium bromide 0.5mg /albuterol sulfate 3mg nebulizer if greater than 1 year of age and more significant respiratory distress (2 times max)

Epinephrine

Contact OLMC prior to administration

• If < 30 kg, 0.15mg IM (0.15 ml of 1:1,000)
• If > 30 kg, 0.3mg IM (0.3 ml of 1:1,000) in anterolateral thigh OR
• Inhalation of nebulized solution of 1ml of 1:1,000 epinephrine mixed with 2ml of normal saline solution.