Pediatric Protocols Flashcards
According to the Pediatric Pain Management protocol what are the 5 treatment options?
Morphine Sulfate Dilaudid Fentanyl Nitrous Oxide Ketamine
According to the Pediatric Pain Management protocol how many medications may be chosen to treat Pediatric Pain?
ONE
According to the Pediatric Pain Management protocol by what routes can Morphine Sulfate be given?
IV/IO
IM
According to the Pediatric Pain Management protocol what is the IV/IO pediatric dose of Morphine Sulfate?
0.1mg/kg
May repeat every 5 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the IM pediatric dose of Morphine Sulfate?
0.1mg/kg
May repeat every 15 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the blood pressure requirement to give Morphine Sulfate?
SBP>100
According to the Pediatric Pain Management protocol by what routes can Dilaudid be given?
IV/IO
IM
According to the Pediatric Pain Management protocol what is the IV/IO pediatric dose of Dilaudid?
0.015 mg/kg
May repeat every 10 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the IM pediatric dose of Dilaudid?
0.015 mg/kg
May repeat every 15 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the blood pressure requirement to give Dilaudid?
SBP>100
According to the Pediatric Pain Management protocol by what routes can Fentanyl be give?
IV/IO
IN
According to the Pediatric Pain Management protocol what is the IV/IO pediatric dose of Fentanyl?
1mcg/kg
May repeat every 3-5 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the IN pediatric dose of Fentanyl?
2 mcg/kg
May repeat every 3-5 minutes
Max 3 doses
According to the Pediatric Pain Management protocol what is the blood pressure requiring to give Fentanyl?
SBP>90
According to the Pediatric Pain Management protocol by what route is Nitrous Oxide given?
Inhalation
According to the Pediatric Pain Management protocol what is the pediatric dose of Nitrous Oxide?
Apply and deliver until pt drops mask
According to the Pediatric Pain Management protocol what 2 situations indicate that Ketamine should be considered above other possible pain medications?
If analgesia and axiolytic is needed
Pt is hypotensive
According to the Pediatric Pain Management protocol by what routes can Ketamine be given?
IV/IM/IO/IN
According to the Pediatric Pain Management protocol what is the IV/IM/IO/IN pediatric dose of Ketamine?
0.1-0.5 mg/kg
Max dose 10 mg
May repeat every 10 minutes
Max 3 doses
According to the Pediatric protocols what is the average weight for a preterm infant?
3lbs (1.4kg)
According to the Pediatric protocols what is the estimated ET tube size for a preterm infant?
2.5, 3.0
According to the Pediatric protocols what are the estimated vitals for a preterm infant?
HR 140
RR 40-60
SPB 50-60
According to the Pediatric protocols what is the average weight for a term infant?
7.5lbs (3.4kg)
According to the Pediatric protocols what is the estimated ET tube size for a term infant?
3.5
According to the Pediatric protocols what are the estimated vitals for a term infant?
HR 125
RR 40-60
SBP 60-70
According to the Pediatric protocols what is the average weight for a 6 month old?
15lbs (6.8kg)
According to the Pediatric protocols what is the estimated ET tube size for a 6 month old?
3.5
According to the Pediatric protocols what are the estimated vitals for a 6 month old?
HR 120
RR 24-36
SBP 60-120
According to the Pediatric protocols what is the average weight for a 1 year old?
22lbs (10kg)
According to the Pediatric protocols what is the estimated ET tube size for a 1 year old?
4.0
According to the Pediatric protocols what are the estimated vitals for a 1 year old?
HR 120
RR 22-30
SBP 65-125
According to the Pediatric protocols what is the average weight for a 3 year old?
33lbs (15kg)
According to the Pediatric protocols what is the estimated ET tube size for a 3 year old?
4.5
According to the Pediatric protocols what are the estimated vitals for a 3 year old?
HR 110
RR 20-26
SBP 100
According to the Pediatric protocols what is the average weight for a 6 year old?
44lbs (20kg)
According to the Pediatric protocols what is the estimated ET tube size for a 6 year old?
5.5
According to the Pediatric protocols what are the estimated vitals for a 6 year old?
HR 100
RR 20-24
SBP 100
According to the Pediatric protocols what is the average weight for an 8 year old?
55lbs (25kg)
According to the Pediatric protocols what is the estimated ET tube size for an 8 year old?
6.0
According to the Pediatric protocols what are the estimated vitals for an 8 year old?
HR 90
RR 18-22
SBP 105
According to the Pediatric protocols what is the average weight for a 10 year old?
66lbs (30kg)
According to the Pediatric protocols what is the estimated ET tube size for a 10 year old?
6.5
According to the Pediatric protocols what are the estimated vitals for a 10 year old?
HR 90
RR 18-22
SBP 110
According to the Pediatric protocols what is the average weight for an 11 year old?
77lbs (35kg)
According to the Pediatric protocols what is the estimated ET tube size for an 11 year old?
6.5
According to the Pediatric protocols what are the estimated vitals for an 11 year old?
HR 85
RR 16-22
SBP 110
According to the Pediatric protocols what is the average weight of a 12 year old?
88lbs (40kg)
According to the Pediatric protocols what is the estimated ET tube size for a 12 year old?
7.0
According to the Pediatric protocols what are the estimated vitals for a 12 year old?
HR 85
RR 16-22
SBP 115
According to the Pediatric protocols what is the average weight for a 14 year old?
99lbs (45kg)
According to the Pediatric protocols what is the estimated ET tube size for a 14 year old?
7.0
According to the Pediatric protocols what are the estimated vitals for a 14 year old?
HR 80
RR 14-20
SBP 115
According to the Pediatric Nausea and Vomiting protocol what are your treatment options?
Zofran
Reglan
According to the Pediatric Nausea and vomiting protocol by what routes can Zofran be given?
IV/IM/IN/IO/PO
According to the Pediatric Nausea and vomiting protocol what is the IV/IM/IN/IO/PO pediatric dose of Zofran?
0.1mg/kg
Up to 4mg
According to the Pediatric Nausea and vomiting protocol what treatment option should be considered first line for Nausea?
Zofran
According to the Pediatric Nausea and vomiting protocol by what routes can Reglan be given?
IV/IM/IO
According to the Pediatric Nausea and vomiting protocol what is the IV/IM/IO pediatric dose of Reglan?
0.1mg/kg
Up to 10mg
According to the Pediatric Nausea and vomiting protocol what treatment option should be considered first line for Active Vomiting?
Reglan
According to the Pediatric Nausea and vomiting protocol if after using one treatment option nausea/vomiting symptoms persist what is your next treatment option?
May give a dose of the other agent
According to the Pediatric Nausea and vomiting protocol if after treatment with Reglan the pt develops a dystonic reaction what is your treatment option?
Benadryl
According to the Pediatric Nausea and vomiting protocol by what routes is Benadryl given to treat a dystonic reaction from treatment with Reglan?
IV/IM/IO
According to the Pediatric Nausea and vomiting protocol what is the IV/IM/IO pediatric dose for Benadryl given to terat a dystonic reaction from treatment with Reglan?
1mg/kg
50mg Max
According to the Pediatric Nausea and vomiting protocol what should you consider for pt with prolonged symptoms or signs of dehydration?
IV access
20cc/kg NS fluid bolus
According to the Pediatric Hyperventilation protocol what are 7 possible causes to consider?
- Diabetic Ketoacidosis
- Metabolic acidosis
- Carbon Monoxide
- Pulmonary Embolus
- Pneumothorax
- Aspirin Overdose
- Toxic Alcohol Poisoning
According to the Pediatric Hyperventilation protocol what assessments should be considered?
Pulse oximetry
Capnography
Cardiac monitoring
12 Lead
According to the Pediatric Hyperventilation protocol what should your first course of action be?
Coach respiratory rate and rhythm
According to the Pediatric Hyperventilation protocol how long do you get to see improvement from coached breathing before you need to consider other options?
5 minutes
According to the Pediatric Hyperventilation protocol if after 5 minutes of coached breathing you do not see improvement what are your next 4 courses of action?
- Re-evaluate respiratory function
- Ensure adequate oxygenation (pulse ox)
- Determine blood glucose level
- Establish IV
According to the Pediatric Hyperventilation protocol if the pt is known to be hyperventilating from anxiety what is your treatment option?
Versed
According to the Pediatric Hyperventilation protocol by what routes is Versed given if the pt is known to be hyperventilating from anxiety?
IV/IO
IN
IM
According to the Pediatric Hyperventilation protocol what is the IV/IO pediatric dose of Versed?
0.1mg/kg
Max dose 2.5mg
May repeat every 5 minutes
Max 2 doses
According to the Pediatric Hyperventilation protocol what is the IN pediatric dose of Versed?
0.2mg/kg
Max dose 2.5mg
May repeat every 5 minutes
Max 2 doses
According to the Pediatric Hyperventilation protocol what is the IM pediatric dose of Versed?
0.2mg/kg
Max dose 2.5mg
May repeat every 10-15 minutes
Max 2 doses
According to the Pediatric Altered Mental Status (AMS) protocol what is the acronym to possible causes of AMS?
AEIOUTIPS
According to the Pediatric Altered Mental Status (AMS) protocol what does the acronym AEIOUTIPS stand for?
A-Alcohol E-Endocrine, Electrolyte I-Insulin O-Overdose U-Uremia T-Trauma I-Infections P-Psychiatric S-Stroke
According to the Pediatric Altered Mental Status (AMS) protocol what is your first assessment?
Blood Glucose Level
According to the Pediatric Altered Mental Status (AMS) protocol when should you refer to the Hypoglycemia protocol?
BG < 80
According to the Pediatric Altered Mental Status (AMS) protocol when should you refer to the Hyperglycemia protocol?
BG > 250
According to the Pediatric Altered Mental Status (AMS) protocol after checking the pts blood glucose level what should your next course of action be?
IV access
12 Lead EKG
Capnography
Cardiac monitoring
According to the Pediatric Altered Mental Status (AMS) protocol what treatment option should you consider if the pt has altered mentation with respiratory depression?
Narcan
According to the Pediatric Altered Mental Status (AMS) protocol by what routes can Narcan be given for the pt with altered mentation and respiratory depression?
IV/IM/ET/IO/IN
According to the Pediatric Altered Mental Status (AMS) protocol what is the IV/IM/ET/IO/IN pediatric dose for the pt with altered mentation and respiratory depression?
0.1mg/kg
Up to 2mg
May continue to repeat every 10 minutes if improving
According to the Pediatric Altered Mental Status (AMS) protocol when should RSI be considered?
If gag depressed
GCS<8
Pt deemed unable to protect airway
According to the Pediatric Mild and Moderate Allergic protocol what are the symptoms of a Mild Allergic Reaction?
Rash
Itching
Hives
According to the Pediatric Mild and Moderate Allergic protocol what are the symptoms of a Moderate Allergic Reaction?
Dyspnea/Wheezing
Mild/moderate angioedema
According to the Pediatric Mild and Moderate Allergic protocol what is the treatment option for Mild Allergic Reactions?
Benadryl
According to the Pediatric Mild and Moderate Allergic protocol by what routes can Benadryl be given for a Mild Allergic reaction?
IV/IM/IO
According to the Pediatric Mild and Moderate Allergic protocol what is the IV/IM/IO pediatric dose of Benadryl for a Mild Allergic Reaction?
1mg/kg
25mg Max
According to the Pediatric Mild and Moderate Allergic protocol what is the initial course of treatment for a Moderate Allergic reaction?
IV access
Cardiac Monitoring
Capnography
Consider 20 cc/kg NS fluid bolus
According to the Pediatric Mild and Moderate Allergic protocol what are the treatment options for a Moderate Allergic Reaction?
Benadryl
Albuterol/Atrovent (Duoneb)
Solumedrol
According to the Pediatric Mild and Moderate Allergic protocol by what routes can Benadryl be given for a Moderate Allergic Reaction?
IV/IM/IO
According to the Pediatric Mild and Moderate Allergic protocol what is the IV/IM/IO pediatric dose of Benadryl for a Moderate Allergic Reaction?
1mg/kg
50mg Max
According to the Pediatric Mild and Moderate Allergic protocol what treatment option should be considered if pt presents with wheezing/dyspnea?
Albuterol/Atrovent (Duoneb)
According to the Pediatric Mild and Moderate Allergic protocol by what route is Albuterol/Atrovent (Duoneb) given in the Moderate Allergic Reaction with wheezing/dyspnea?
Nebulized
According to the Pediatric Mild and Moderate Allergic protocol what is the pediatric dose for Albuterol/Atrovent (Duoneb)?
Albuterol 2.5mg with Atrovent 500mcg (Duoneb)
May repeat 2 times
According to the Pediatric Mild and Moderate Allergic protocol if a pt is <1 and has a Moderate Allergic Reaction with wheezing/dyspnea what is the dose of Albuterol/Atrovent (Duoneb)?
Half dose of Albuterol/Atrovent (Duoneb)
According to the Pediatric Mild and Moderate Allergic protocol by what routes can Solumedrol be given?
IV/IO/IM
According to the Pediatric Mild and Moderate Allergic protocol what is the IV/IO/IM pediatric dose for Solumedrol?
2mg/kg
125mg Max
According to the Pediatric Mild and Moderate Allergic protocol if the pt does not improve despite treatments what is your next course of action?
Proceed to Pediatric Severe Allergic Reaction Protocol
According to the Pediatric Severe Allergic Reaction protocol what are the symptoms of a Severe Allergic Reaction?
Severe dyspnea
Severe angioedema
Hypotension
Altered mental status
According to the Pediatric Severe Allergic Reaction protocol what should you consider early in your treatment plan?
Early airway intervention
(RSI?)
(Surgical airway?)
According to the Pediatric Severe Allergic Reaction protocol what is you initial course of action?
IV access
Capnography
Cardiac monitoring
Consider 2nd IV
According to the Pediatric Severe Allergic Reaction protocol what are your treatment options for upper airway involvement and/or stridor?
Racemic Epinephrine
Epinephrine 1:1,000
Pediatric Epinephrine Pen
According to the Pediatric Severe Allergic Reaction protocol what is your pediatric dose of Racemic Epinephrine if your pt is <4 years old?
- 05 ml/kg
0. 5 ml Max
According to the Pediatric Severe Allergic Reaction protocol what is your pediatric dose of Racemic Epinephrine if your pt is >4 years old?
0.5 ml
According to the Pediatric Severe Allergic Reaction protocol by what route can Epinephrine 1:1,000 be given for upper airway involvement and/or stridor?
IM
According to the Pediatric Severe Allergic Reaction protocol what is the IM pediatric dose of Epinephrine 1:1,000?
0.01 mg/kg
0.3 Max
May repeat every 5-10 minutes if needed
According to the Pediatric Severe Allergic Reaction protocol how do you calculate the appropriate SBP for a pediatric pt?
70 + 2(Age)
According to the Pediatric Severe Allergic Reaction protocol what is the treatment option for a hypotensive pt?
20 cc/kg NS fluid bolus
According to the Pediatric Severe Allergic Reaction protocol what are your treatment options?
Benadryl
Albuterol/ Atrovent (Duoneb)
Solumedrol
According to the Pediatric Severe Allergic Reaction protocol what is your treatment option if pt remains hypotensive despite fluid bolus?
Epinephrine Push Dose Presser
According to the Pediatric Severe Allergic Reaction protocol by what route is the Epinephrine Push Dose Presser given to the hypotensive pt not responsive to a fluid bolus?
IV
According to the Pediatric Severe Allergic Reaction protocol what is the IV pediatric dose of the Epinephrine Push Dose Presser given to the hypotensive pt not responsive to a fluid bolus?
0.5-2ml every 2-5 minutes for SBP < [70 + 2(Age)]
According to the Pediatric Severe Allergic Reaction protocol if no improvement after treatments why should intubation be considered early?
Early intubation is paramount as laryngeal edema and spasm can progress rapidly
According to the Pediatric Diabetic Emergencies-Hyperglycemia protocol what is the criteria for Pediatric Hyperglycemia?
BG>250 mg/dcl
According to the Pediatric Diabetic Emergencies-Hyperglycemia protocol what is your initial course of action for the Pediatric Hyperglycemia pt?
IV access
Consider capnography
NS fluid bolus 20 cc/kg and repeat to maintain SBP> 70 + 2(Age)
According to the Pediatric Diabetic Emergencies-Hyperglycemia protocol what are 5 pertinent histories to obtain?
Diabetic? If so...taking medications/insulin? Fever? Nausea/ Vomiting? Polydipsia? Polyuria?
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the criteria for Pediatric Hypoglycemia?
BG < 80
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol if the pt BG is <80 what should you next consider?
Pt Level of consciousness
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol if the pt is able to control their airway what is you treatment option?
1 tube Oral Glucose
Repeat as needed
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol if the pt has altered mentation and is age 0-2 years old what is your treatment option?
Dextrose 25%
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol by what routes can Dextrose 25% be given for a pt who has altered mentation and is age 0-2 years old?
IV/IO
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the IV/IO pediatric dose of Dextrose 25% given for a pt who has altered mentation and is age 0-2 years old?
4ml/kg
May repeat up to 2 times if needed to keep blood glucose >80
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol if the pt has altered mentation and is >2 years old what is the treatment option?
Dextrose 50%
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol by what route is Dextrose 50% given for the pt with altered mentation >2 years old?
IV/IO
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the IV/IO pediatric dose for Dextrose 50% given for the pt with altered mental status >2 years old?
2ml/kg
May repeat up to 2 times if needed to keep blood glucose >80
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the next course of action if unable to establish IV access for the pt with altered mental status
Glucagon
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol by what route is Glucagon given for the pt with altered mental status for whom you have not been able to establish IV access?
IM
IN
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the IM pediatric dose for Glucagon given to a pt <20 kg?
0.5mg
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the IN pediatric dose for Glucagon given to a pt <20kg?
1mg
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the IM pediatric dose for Glucagon given to a pt >20kg?
1mg
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the IN pediatric dose for Glucagon given to a pt >20kg?
2mg
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol if a pt has altered mentation and appears malnourished what is treatment option should be considered?
Thiamine
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol by what route is Thiamine given to the pt with altered mental status who appears malnourished?
IV/IM/IO
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the IV/IM/IO pediatric dose for Thiamine given to the pt with altered mental status who appears malnourished?
10-25mg
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol what is the age requirement to treat a pt who is malnourished with altered mental status with Thiamine?
> 12 years old
According to the Pediatric Diabetic Emergencies-Hypoglycemia protocol if a pt remains unresponsive to therapy what is the next course of action?
Refer to Pediatric Altered Mental Status Protocol
According to the Pediatric Environmental Emergencies-Hyperthermia protocol what is the definition of Hyperthermia?
Core temperature >102 degrees F
According to the Pediatric Environmental Emergencies-Hyperthermia protocol what is the definition of Heat Stroke?
Hyperthermia with hypotension, altered mental status, hypotension and/or tachycardia
According to the Pediatric Environmental Emergencies-Hyperthermia protocol what should you obtain in your treatment/ assessment?
IV access
Cardiac monitoring
Capnography
12 Lead EKG
According to the Pediatric Environmental Emergencies-Hyperthermia protocol what are 3 things you should do for the pt early in treatment?
Move to a cooler environment
Remove excess clothing
Apply tepid compresses to forehead, neck, extremities
According to the Pediatric Environmental Emergencies-Hyperthermia protocol in a heat stroke what is your treatment option?
20cc/kg NS fluid bolus
Repeat to maintain SBP > 70 + 2(Age)
According to the Pediatric Environmental Emergencies-Hyperthermia protocol what kind of cooling should you provide?
Aggressive cooling with wet sheets and cold packs to the neck, axilla, and femoral regions
According to the Pediatric Environmental Emergencies-Hypothermia protocol what is the definition of Hypothermia?
Core Temperature less than 95 degrees F
According to the Pediatric Environmental Emergencies-Hypothermia protocol what are the 8 steps for caring for Systemic Hypothermia?
- Refer to appropriate dysrhythmia protocol
- Carefully remove wet clothing (cut don’t pull off)
3 Insulate from cold. Keep vehicle warm - Wrap pt in warm blankets
- Apply heat packs to head, neck, chest, axilla, and groin
- Use IV re-warming units if available
- Provide gentle handling and transport ASAP
- Consider 12 Lead, cardiac monitoring, and capnography depending on severity
According to the Pediatric Environmental Emergencies-Hypothermia protocol what are the 4 steps for caring for Localized Hypothermia?
- Gently removed clothing from affected area
- Protect area from pressure or friction
- Rewarm with blankets and body heat
- Assess for systemic hypothermia
According to the Pediatric Environmental Emergencies-Hypothermia protocol at what temperature may the heart not respond to cardiac medications?
<86 degrees F
According to the Pediatric Environmental Emergencies-Hypothermia protocol prior to pt reaching 92 degrees F what should occur with PALS medications?
Only one course of PALS drugs prior to pt being rewarmed to 92 degrees F
According to the Pediatric Seizures protocol what should be obtained and/or assessed?
IV access Cardiac monitoring Capnography when able 12 Lead if new onset seizure Blood glucose level
According to the Pediatric Seizures protocol what 5 things should you consider as potential causes for the seizure?
- Head injury
- Overdose
- Fever
- Hypoxia
- Recurrent seizure
According to the Pediatric Seizures protocol what ensure about a pt experiencing febrile seizures?
Not excessively dressed
According to the Pediatric Seizures protocol if the pt is still seizing what is your treatment option?
Versed
According to the Pediatric Seizures protocol by what routes is Versed given for the pt who is still seizing?
IV/IO
IN
IM
According to the Pediatric Seizures protocol what is the IV/IO pediatric dose for Versed given to the pt who is still seizing?
0.1 mg/kg
Max dose 5mg
May repeat every 2-3 minutes
Max 3 doses
According to the Pediatric Seizures protocol what is the IN pediatric dose for Versed given to the pt who is still seizing?
0.2mg/kg
Max dose 5mg
May repeat every 2-3 minutes
Max 3 doses
According to the Pediatric Seizures protocol what is the IM pediatric dose for Versed given to the pt who is still seizing?
0.2mg/kg
Max dose 5mg
May repeat every 10-15 minutes
Max 2 doses
According to the Pediatric Overdose/Poisoning protocol what is the phone number to poison control?
1-800-222-1222
According to the Pediatric Overdose/Poisoning protocol what should occur if external contamination?
Protect medical and rescue personnel
Remove contaminated clothing
Brush solid material from skin
According to the Pediatric Overdose/Poisoning protocol what should be assessed/ obtained?
Blood glucose level IV access 12 Lead Capnography Cardiac monitoring
According to the Pediatric Overdose/Poisoning protocol how should hypotension initially be treated?
NS fluid bolus to maintain SBP> (70 + 2(Age))
According to the Pediatric Overdose/Poisoning protocol if hypotension is not responding to NS fluid bolus what is your next treatment options?
Epinephrine Push Dose Presser
According to the Pediatric Overdose/Poisoning protocol what is your treatment option if pt present with altered mentation and respiratory depression?
Narcan
According to the Pediatric Overdose/Poisoning protocol by what routes can Narcan be given for the pt with altered mentation and respiratory depression?
IV/IM/ET/IO/IN
According to the Pediatric Overdose/Poisoning protocol what is the IV/IM/ET/IO/IN pediatric dose for Narcan given for the pt with altered mentation and respiratory depression?
0.1 mg/kg
May repeat every 10 minutes if improving
According to the Pediatric Overdose/Poisoning protocol what should occur if pt gag is depressed and pt deemed unable to protect airway?
Establish and protect airway
According to the Pediatric Overdose/Poisoning protocol what is the kind of poisoning is Cholinergic?
Organo-phosphate Insecticides
According to the Pediatric Overdose/Poisoning protocol what is the acronym use to describe symptoms found in a Cholinergic poisoning?
SLUDGE
According to the Pediatric Overdose/Poisoning protocol what does that acronym SLUDGE stand for?
S-Salivation L-Lacrimation U-Urination D-Defecation G-GI Distress E-Emesis
According to the Pediatric Overdose/Poisoning protocol what is the treatment option for a pt with a Cholinergic poisoning?
Atropine
According to the Pediatric Overdose/Poisoning protocol by what routes can Atropine be given for a pt with a Cholinergic poisoning?
IV/ET/IO
According to the Pediatric Overdose/Poisoning protocol what is the IV/ET/IO pediatric dose for Atropine given for a pt with a Cholinergic poisoning?
0.02 mg/kg
May repeat every 5 minutes until secretions diminish
According to the Pediatric Overdose/Poisoning protocol what are the signs and symptoms of a Tricyclic Antidepressant Overdose?
Increased HR-first warning sign
Increased BP worsening
Decreased BP (with possible ectopy, seizures, and cardiac arrest)
According to the Pediatric Overdose/Poisoning protocol what is the first warning sign of a Tricyclic Antidepressant Overdose?
Increased HR
According to the Pediatric Overdose/Poisoning protocol what is your course of action for a Tricyclic Antidepressant Overdose?
Hyperventilate in assisting respiration
If tachycardia, dysrhythmias, or widening QRS (>0.1 second) administer Sodium Bicarbonate
According to the Pediatric Overdose/Poisoning protocol if a Tricyclic Antidepressant Overdose is suspected and pt presents with tachycardia, dysrhythmias, or widening QRS (>0.1 second) what is your treatment option?
Sodium Bicarbonate
According to the Pediatric Overdose/Poisoning protocol by what route can Sodium Bicarbonate be given for the suspected Tricyclic Antidepressant Overdose presenting with tachycardia, dysrhythmias, or widening QRS (>0.1 second)?
1 meq/kg
According to the Pediatric Overdose/Poisoning protocol what is an environmental finding with Cyanide poisoning?
Odor of bitter almonds
According to the Pediatric Overdose/Poisoning protocol what is your course of action with a Beta-Blocker or Calcium Channel Blocker overdose?
Call Medical Control for further guidance
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol what are the 10 signs and symptoms of Mild to Moderate Respiratory Distress?
- Shortness of breath
- Wheezes
- Cough
- Tachypnea
- Increased respiratory effort
- Mild retractions
- Decreased air movement
- Normal to slightly abnormal O2 saturations (>94%)
- Able to complete long phrases/sentences
- Normal Capnography
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol what should you consider obtaining?
IV access
Capnography
Cardiac monitoring if pt is moderate or worsening
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol what should you consider as a cause of the respiratory distress?
Upper airway obstruction
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol if the cause of the respiratory distress is found to be an upper airway obstruction what should your course of action be?
BLS choking maneuvers
Magill forceps removal
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol if the clinical picture suggests asthma/bronchiolitis and/or wheezing/poor air movement what are your treatment options?
Albuterol/Atrovent (Duoneb)
Solumedrol
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol by what route is Albuterol/Atrovent (Duoneb) given?
Nebulized
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol what is the pediatric dose of Albuterol/Atrovent (Duoneb)?
Albuterol 2.5mg with Atrovent 500mcg (Duoneb)
May repeat twice
If age < 1 use half dose
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol if the pt is <1 year old what is the dose of Albuterol/Atrovent (Duoneb)?
Half dose
May repeat twice
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol by what routes can Solumedrol be given?
IV/IO/IM
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol what is the IV/IO/IM pediatric dose of Solumedrol?
2 mg/kg
125mg Max
According to the Pediatric Respiratory Distress (Mild to Moderate) protocol if pt does not improve despite treatments what is your next course of action?
Proceed to the Pediatric Respiratory Distress Severe Protocol
According to the Pediatric Respiratory Distress (Severe) protocol what are the 9 signs and symptoms of a Severe Respiratory Distress?
- Impending respiratory failure
- Grunting
- Severe retractions/ accessory muscle use
- Abnormal O2 saturations (<93%)
- Capnography CO2 >50mmHg
- 1-3 syllable phrases
- Cyanosis
- Decreased LOC
- Hypotension (SBP<70 or <70+2(Age))
According to the Pediatric Respiratory Distress (Severe) protocol what should you obtain?
IV access
Capnography
Cardiac monitoring
According to the Pediatric Respiratory Distress (Severe) protocol what should you consider as a cause for the respiratory distress?
Upper airway obstruction
According to the Pediatric Respiratory Distress (Severe) protocol if the clinical picture suggests asthma or bronchiolitis with wheezing and/or poor air movement what are your treatment options?
Albuterol/Atrovent (Duoneb)
Solumedrol
According to the Pediatric Respiratory Distress (Severe) protocol what tool should you consider for use if age appropriate?
CPAP
According to the Pediatric Respiratory Distress (Severe) protocol if the pt presents with Stridor what is your treatment option?
Racemic Epinephrine
According to the Pediatric Respiratory Distress (Severe) protocol by what route is Racemic Epinephrine given?
Nebulized
According to the Pediatric Respiratory Distress (Severe) protocol what is the pediatric dose of Racemic Epinephrine for the pt who is <4 years old?
- 05 ml/kg
0. 5ml Max
According to the Pediatric Respiratory Distress (Severe) protocol what is the pediatric dose of Racemic Epinephrine for the pt who is >4 years old?
0.5 ml
According to the Pediatric Respiratory Distress (Severe) protocol if despite treatment pt symptoms continued what are your treatment options?
Magnesium Sulfate
Epinephrine 1:1,000
According to the Pediatric Respiratory Distress (Severe) protocol by what routes can Magnesium Sulfate be given?
IV/IO
According to the Pediatric Respiratory Distress (Severe) protocol what is the IV/IO pediatric dose of Magnesium Sulfate?
25-50mg/kg
2 grams Max
Over 20 minutes
(May mix in 100 ml NS over 20 minutes)
According to the Pediatric Respiratory Distress (Severe) protocol by what routes can Epinephrine 1:1,000 be given?
IM
According to the Pediatric Respiratory Distress (Severe) protocol what is the IM pediatric dose of Epinephrine 1:1,000?
0.01 mg/kg
0.3mg Max
May repeat once in 10 minutes if no change
According to the Pediatric Respiratory Distress (Severe) protocol if all treatment options have been exhausted and pt still has experienced no improvement what is your next course of action?
RSI
According to the Pediatric Bradycardia protocol what is your first course of action?
Support ABC’s
Give oxygen
Consider capnography
Attach monitor/ defibrillator
According to the Pediatric Bradycardia protocol what question should you ask yourself concerning the pt presentation?
Is bradycardia causing cardiorespiratory compromise?
According to the Pediatric Bradycardia protocol if the bradycardia is NOT causing cardiorespiratory compromise what is your course of action?
Support ABC’s
Give oxygen as needed
Observe and transport
According to the Pediatric Bradycardia protocol if the bradycardia IS causing cardiorespiratory compromise what is your course of action?
CPR if HR <60
Epinephrine 1:10,000
Epinephrine 1:1,000
According to the Pediatric Bradycardia protocol if the pt HR is <60 what is your first course of action?
CPR
According to the Pediatric Bradycardia protocol what is the rate of the CPR if the pt HR is <60?
100/min
Hard and fast
Allow for full recoi
According to the Pediatric Bradycardia protocol by what routes can Epinephrine 1:10,000 be given for the bradycardic pt?
IV/IO
According to the Pediatric Bradycardia protocol what is the IV/IO pediatric dose of Epinephrine for the bradycardic pt?
0.01 mg/kg
May repeat every 3-5 minutes
According to the Pediatric Bradycardia protocol by what route can Epinephrine 1:1,000 be given for the bradycardic pt?
ET
According to the Pediatric Bradycardia protocol what is the ET pediatric dose of Epinephrine 1:1,000 for the bradycardic pt?
0.1 mg/kg
May repeat every 3-5 minutes
According to the Pediatric Bradycardia protocol if the pt is resistant to treatment with CPR and/or Epinephrine what treatment option should you then consider?
Atropine
According to the Pediatric Bradycardia protocol by what routes can Atropine be given to the bradycardic pt resistant to treatments with CPR and Epinephrine?
IV/IO/ET
According to the Pediatric Bradycardia protocol what is the IV/IO/ET pediatric dose of Atropine for the bradycardic pt resistant to treatments with CPR and Epinephrine?
0.02 mg/kg
Max 1mg
According to the Pediatric Bradycardia protocol if pt has been resistant to all treatments and is still experiencing cardiorespiratory compromise what is your next course of action?
Transcutaneous pacing
According to the Pediatric Bradycardia protocol if the pt improves what is your next course of action?
Continue to support and transport
According to the Pediatric Bradycardia protocol if the pt develops pulseless cardiac arrest what is your next course of action?
Refer to Pediatric Cardiac Arrest Protocol
According to the Pediatric Tachycardia protocol what is your initial course of action?
Support ABC’s
Give oxygen
Consider capnography
Attach monitor/ defibrillator
According to the Pediatric Tachycardia protocol what should you ask yourself concerning the pt presentation?
Is the tachycardia unstable?
According to the Pediatric Tachycardia protocol what is meant by unstable tachycardia?
Causing cardiorespiratory compromise
According to the Pediatric Tachycardia protocol after considering whether or not the tachycardia is stable what should you obtain?
12 Lead
According to the Pediatric Tachycardia protocol what should you evaluate about the 12 Lead to determine your course of action?
QRS duration
According to the Pediatric Tachycardia protocol what question are your asking yourself about the QRS duration while evaluating it?
Is the QRS narrow?
According to the Pediatric Tachycardia protocol what is considered a narrow QRS?
<= 0.09 seconds
According to the Pediatric Tachycardia protocol what should you ask yourself concerning the rhythm of the pt 12 Lead?
Is it Sinus Tachycardia?
According to the Pediatric Tachycardia protocol what 3 clues from the EKG rhythm indicate a Sinus Tachycardia?
- P waves present/normal
- Constant R-R or Variable
- Rate usually <220 in infants and <180 in children
According to the Pediatric Tachycardia protocol what is your next course of action if the 12 Lead analysis reveals Sinus Tachycardia?
Search for and treat cause (dehydration, fever, ingestion, etc.)
According to the Pediatric Tachycardia protocol what treatment options should you consider when treating a pt who’s rhythm has been determined to be Sinus Tachycardia?
Consider 20 cc/kg NS bolus
If fever consider up-wrapping child
If suspicion of ingestion see Pediatric Overdose/Poisoning protocol
According to the Pediatric Tachycardia protocol when considering SVT what clues are you looking for?
Does pt have a history of SVT?
P waves absent
Heart rate not variable
Rate usually >220 in infants and >180 in children
According to the Pediatric Tachycardia protocol if the rhythm is believed to be SVT and the pt is considered Stable what is your first course of action?
Vagal Maneuvers
According to the Pediatric Tachycardia protocol if the rhythm is believed to be SVT and the pt is considered stable what is your treatment option after vagal maneuvers?
Adenosine
According to the Pediatric Tachycardia protocol by what route can Adenosine be given if the rhythm is believed to be SVT and the pt is considered Stable?
IV
According to the Pediatric Tachycardia protocol what is the IV pediatric dose of Adenosine given to the stable pt who’s rhythm is interpreted as SVT?
0.1 mg/kg
Max 6mg
RAPID with 10cc NS bolus
According to the Pediatric Tachycardia protocol what is your next course of action if your stable pt with SVT is resistant to the first dose of Adenosine?
Repeat Adenosine
Double first dose (Max 12mg)
According to the Pediatric Tachycardia protocol what is your next treatment option if your stable pt with SVT remains resistant after 2 rounds of Adenosine?
Amiodarone
According to the Pediatric Tachycardia protocol by what route is Amiodarone given to the stable pt with SVT resistant to 2 rounds of Adenosine?
IV/IO
According to the Pediatric Tachycardia protocol what is the IV/IO pediatric dose of Amiodarone given to the stable pt with SVT who remains resistant after 2 rounds of Adenosine?
5mg/kg
Over 20 minutes
According to the Pediatric Tachycardia protocol if your pt is found to be Unstable with SVT what is your treatment option?
Synchronized Cardioversion
According to the Pediatric Tachycardia protocol what is the pediatric dose of Synchronized Cardioversion for the Unstable pt with SVT?
0.5-1 J/kg
According to the Pediatric Tachycardia protocol what is your next course of action if your Unstable pt with SVT is resistant to initial synchronized cardioversion?
Increase Synchronized Cardioversion to 2 J/kg
According to the Pediatric Tachycardia protocol what should your consider to your pt when using synchronized cardioversion?
Sedation
According to the Pediatric Tachycardia protocol what treatment option is used for sedation when using synchronized cardioversion?
Etomidate
According to the Pediatric Tachycardia protocol by what routes can Etomidate be given for sedation when using synchronized cardioversion?
IV/IO
According to the Pediatric Tachycardia protocol what is the IV/IO pediatric dose of Etomidate given for sedation when using synchronized cardioversion?
0.1 mg/kg
According to the Pediatric Tachycardia protocol what is considered a Wide QRS?
QRS >= 0.09 seconds
According to the Pediatric Tachycardia protocol if the QRS is determined Wide what should you consider about the rhythm?
Possible V-tach
According to the Pediatric Tachycardia protocol if the pt rhythm is determined to be possible V-tach and the pt is stable what is your treatment option?
Amiodarone
According to the Pediatric Tachycardia protocol by what route is Amiodarone given to the stable pt who’s rhythm is determined to be possible V-tach?
IV/IO
According to the Pediatric Tachycardia protocol what is the IV/IO pediatric dose for Amiodarone given to the stable pt who’s rhythm is determined to be possible V-tach?
5 mg/kg
Over 20 minutes
According to the Pediatric Tachycardia protocol if the stable pt with V-tach converts with Amiodarone what is your next course of action?
Observe and transport
Contact ER to notify to have Amiodarone drip prepared
According to the Pediatric Tachycardia protocol if the stable pt with V-tach who converted with Amiodarone returns to initial rhythm what is your next course of action?
Repeat Amiodarone
5 mg/kg IV/IO over 20 minutes
According to the Pediatric Tachycardia protocol if the stable pt with V-tach is resistant to Amiodarone what treatment option should you consider?
Adenosine
According to the Pediatric Tachycardia protocol by what route is Adenosine given to the stable pt with V-tach who is resistant to Amiodarone?
IV
According to the Pediatric Tachycardia protocol what is the IV pediatric dose for the stable pt with V-tach who is resistant to Amiodarone?
0.1 mg/kg
Max 6 mg
Rapid with 10cc NS bolus
According to the Pediatric Tachycardia protocol if the pt is determined to be in V-tach but is Unstable what is your course of action?
Synchronized cardioversion
According to the Pediatric Tachycardia protocol what is the pediatric dose of synchronized cardioversion for the Unstable pt with V-tach?
0.5-1 J/kg
According to the Pediatric Tachycardia protocol what is your next course of action for the Unstable pt with V-tach who is resistant to the first round of synchronized cardioversion?
Synchronize cardiovert at 2 J/kg
According to the Pediatric Tachycardia protocol what treatment option should you consider for your pt who you are going to synchronize cardiovert?
Etomidate
According to the Pediatric Tachycardia protocol if your pt develops pulseless cardiac arrest what is your next course of action?
Pediatric Cardiac Arrest Protocol
According to the Pediatric Cardiac Arrest protocol what is the rate for compressions during CPR?
100-120 compressions/minute
Hard and fast
Allow for full recoil
According to the Pediatric Cardiac Arrest protocol what are your initial treatments other than CPR?
Support ABC's Give oxygen Attach monitor/ defibrillator Establish IV/IO Establish airway AFTER 600 compressions
According to the Pediatric Cardiac Arrest protocol what treatment option should you consider for all pts with unwitnessed arrest, prolonged downtime, or persistent PEA?
Sodium Bicarbonate
According to the Pediatric Cardiac Arrest protocol what question should you ask yourself concerning the EKG rhythm?
Is the rhythm shockable?
According to the Pediatric Cardiac Arrest protocol if the rhythm is shockable after your first round of compressions what is your next treatment option?
1 Shock
According to the Pediatric Cardiac Arrest protocol what is the pediatric dose for the first defibrillation?
2 J/kg (manual)
or
AED if pt >1 year old
According to the Pediatric Cardiac Arrest protocol after first defibrillation what is your immediate next treatment?
Resume CPR (5 cycles/ 2 minutes)
According to the Pediatric Cardiac Arrest protocol if after your second round of CPR your rhythm analysis continues to find pt in a shockable rhythm what is your next treatment option?
1 Shock
According to the Pediatric Cardiac Arrest protocol what is the pediatric dose for the second defibrillation?
4 J/kg (manual)
or
AED if pt >1 year old
According to the Pediatric Cardiac Arrest protocol after your second defibrillation what is your immediate next treatment?
Resume CPR (5 cycles/ 2 minutes)
According to the Pediatric Cardiac Arrest protocol what is the pediatric defibrillation dose for every shock given after your second defibrillation?
4 J/kg
or
AED if pt >1 year old
According to the Pediatric Cardiac Arrest protocol what are your treatment options during your 3rd round of CPR?
Epinephrine 1:10,000
Epinephrine 1:1,000
According to the Pediatric Cardiac Arrest protocol by what route can Epinephrine 1:10,000 be given?
IV/IO
According to the Pediatric Cardiac Arrest protocol what is the IV/IO pediatric dose of Epinephrine 1:10,000?
0.01 mg/kg
May repeat every 3-5 minutes
According to the Pediatric Cardiac Arrest protocol by what route can Epinephrine 1:1,000 be given?
ET
According to the Pediatric Cardiac Arrest protocol what is the ET pediatric dose of Epinephrine 1:1,000?
0.1 mg/kg
May repeat every 3-5 minutes
According to the Pediatric Cardiac Arrest protocol after Epinephrine what is your next treatment option for the pt in a shockable rhythm?
Amiodarone
According to the Pediatric Cardiac Arrest protocol by what routes is Amiodarone given to the pt in a shockable rhythm?
IV/IO
According to the Pediatric Cardiac Arrest protocol what is the IV/IO pediatric dose of Amiodarone given to the pt in a shockable rhythm?
5 mg/kg
May repeat same dose once
According to the Pediatric Cardiac Arrest protocol what is the treatment option for the pt in Torsades de Pointes?
Magnesium
According to the Pediatric Cardiac Arrest protocol by what route can Magnesium be given to the pt in Torsades de Pointes?
IV/IO
According to the Pediatric Cardiac Arrest protocol what is the IV/IO pediatric dose of Magnesium for the pt in Torsades de Pointes?
25-50 mg/kg
Max 2 grams
According to the Pediatric Cardiac Arrest protocol if the pt is hypothermic what medication should be withheld until the pt is warmed to 92 degress F?
Amiodarone
According to the Pediatric Cardiac Arrest protocol if the pt converts with Amiodarone what is the next treatment option?
Observe and transport
Contact ER and notify to have Amiodarone drip prepared
According to the Pediatric Cardiac Arrest protocol if the pt experiences a return of spontaneous circulation what is the next course of action?
Continue supportive care
According to the Pediatric Cardiac Arrest protocol if the pt experiences a return of spontaneous circulation what treatment option should be considered?
Epinephrine Push Dose Presser
According to the Pediatric Cardiac Arrest protocol by what route is the Epinephrine Push Dose Presser given?
IV
According to the Pediatric Cardiac Arrest protocol what is the IV pediatric dose for the Epinephrine Push Dose Presser?
0.5-2 ml every 2-5 minutes for SBP < 70 + 2(Age)
According to the Pediatric Cardiac Arrest protocol what rhythms are considered Unshockable?
Asystole
PEA
According to the Pediatric Cardiac Arrest protocol if the rhythm analysis finds the pt in an unshockable rhythm what is your treatment option?
Epinephrine 1:10,000
Epinephine 1:1,000
According to the Pediatric Cardiac Arrest protocol if the pt is in an unshockable rhythm what is the course of treatment?
Continued CPR and Epinephrine
According to the Pediatric Cardiac Arrest protocol what are the capnography goals?
35-45 mmHg ideally
According to the Pediatric Cardiac Arrest protocol what does a capnography < 10mmHg indicate?
Inadequate CPR/ ventilation
