ALS PCS: Bronchoconstriction Medical Directive

Question 1

INDICATIONS

Answer 1

RESPIRATORY DISTRESS

AND

SUSPECTED BRONCHOCONSTRICTION

Question 2

CONDITIONS (SALBUTAMOL)

Answer 2

N/A

Question 3

CONDITIONS (EPINEPHRINE)

Answer 3

RR: BVM VENTILATION REQUIRED

OTHER: Hx OF ASTHMA

Question 4

CONTRAINDICATIONS (SALBUTAMOL)

Answer 4

ALLERGY OR SENSITIVITY TO SALBUTAMOL

Question 5

CONTRAINDICATIONS (EPINEPHRINE)

Answer 5

ALLERGY OR SENSITIVITY TO EPINEPHRINE

Question 6

TREATMENT (SALBUTAMOL)
WEIGHT <25kg
ROUTE: MDI

Answer 6

DOSE: UP TO 600mcg (6 PUFFS)

MAX SINGLE DOSE: 600mcg

DOSING INTERVAL: 5 - 10 mins PRN

MAX # OF DOSES: 3

Question 7

TREATMENT (SALBUTAMOL)
WEIGHT <25
ROUTE: NEB

Answer 7

DOSE: 2.5mg

MAX SINGLE DOSE: 2.5mg

DOSING INTERVAL: 5 - 15 mins PRN

MAX # OF DOSES: 3

Question 8

TREATMENT (SALBUTAMOL)
WEIGHT ≥ 25kg
ROUTE: MDI

Answer 8

DOSE: UP TO 500mcg (8 PUFFS)

MAX SINGLE DOSE: 800mcg

DOSING INTERVAL: 5 - 15 min PRN

MAX # OF DOSES: 3

Question 9

TREATMENT (SALBUTAMOL)
WEIGHT ≥ 25kg
ROUTE: NEB

Answer 9

DOSE: 5mg

MAX SINGLE DOSE: 5mg

DOSING INTERVAL: 5 - 15 mins PRN

MAX # OF DOSES: 3

Question 10

TREATMENT (EPINEPHRINE)

Answer 10

ROUTE: IM

CONCENTRATION: 1mg/mL = 1:1000

DOSE: 0.01mg/kg

MAX SINGLE DOSE: 0.5mg

DOSING INTERVAL: N/A

MAX # OF DOSES: 1

Question 11

CLINICAL CONSIDERATIONS

Answer 11

EPINEPHRINE SHOULD BE 1st MEDICATION ADMINISTERED IF PATIENT IS APNEIC. SALBUTAMOL MDI MAY BE ADMINISTERED SUBSEQUENTLY USING A BVM MDI ADAPTER

NEBULIZATION IS CONTRAINDICATED IN PATIENTS WITH A KNOWN OR SUSPECTED FEVER OR IN THE SETTING OF A DECLARED FEBRILE RESPIRATORY ILLNESS OUTBREAK BY THE LOCAL MEDICAL OFFICER OF HEALTH