Maine:Prehospital protocol pediatric anaphylaxis: Difference between revisions
Ostermayer (talk | contribs) (Created page with "==Perform general assessment== #Manage airway as appropriate #If shock is present refer to shock protocol #Request ALS if available ==Signs Symptoms of Anapylaxis?== #Is ther...") |
(Text replacement - "Epinephine" to "Epinephrine") |
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*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 | ||
==Wheezing or Shortness of Breath?== | ==Wheezing or Shortness of Breath?== | ||
| Line 21: | Line 21: | ||
*Repeat as needed | *Repeat as needed | ||
==Give Diphenhydramine 1- | ==Give Diphenhydramine 1-2mg/kg IV/IM== | ||
*Max dose 50mg | *Max dose 50mg | ||
==Notify Receiving Hospital== | ==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 or repeat epinephrine dosing | ||
==[[Epinephrine]]drip preparation== | |||
This must be performed under OLMC and only with a Maine EMS approved pump | |||
*'''Preparation:''' add 1 mL (1mg) epinephrine (1mg/ml 1:1000) to a 250 mL bag NS. This results in 1mg/250mL = 4mcg/mL mix | |||
*'''Dose:''' start at 0.05mcg/kg/min Titrate by 0.05 mcg/kg/min every 5 min to desired BP | |||
*'''Usual dose:''' is 0.05-0.5 mcg/kg/min. MAX dose 0.5mcg/kg/min | |||
Latest revision as of 15:11, 25 May 2017
Perform general assessment
- Manage airway as appropriate
- If shock is present refer to shock protocol
- Request ALS if available
Signs Symptoms of Anapylaxis?
- Is there a known allergen exposure with hypotension or respiratory distress?
- Common allergens are peanuts, medications and bee stings
Yes
- Assist in administration of patient's own anaphylaxis kit if available
- 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
Wheezing or Shortness of Breath?
- 2.5mg/3mL NS via Nebulizer may be administered
- Repeat as needed
Give Diphenhydramine 1-2mg/kg IV/IM
- Max dose 50mg
Notify Receiving Hospital
- Continue transport, and frequent reassessments
- Contact online medical control if in need of further instructions or repeat epinephrine dosing
Epinephrinedrip preparation
This must be performed under OLMC and only with a Maine EMS approved pump
- Preparation: add 1 mL (1mg) epinephrine (1mg/ml 1:1000) to a 250 mL bag NS. This results in 1mg/250mL = 4mcg/mL mix
- Dose: start at 0.05mcg/kg/min Titrate by 0.05 mcg/kg/min every 5 min to desired BP
- Usual dose: is 0.05-0.5 mcg/kg/min. MAX dose 0.5mcg/kg/min