Acute Asthma or COPD with Wheezing - Revision history

Treloars at 14:28, 24 April 2020

2020-04-24T14:28:51Z

← Older revision		Revision as of 14:28, 24 April 2020
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	'''DO NOT DELAY TRANSPORT WAITING FOR RESPONSE OF TREATMENT.'''		'''DO NOT DELAY TRANSPORT WAITING FOR RESPONSE OF TREATMENT.'''

	:If bronchospasm worsens despite treatment, respiratory failure is imminent, or patient exhibits with an altered mental status, perform endotracheal intubation and ventilate with [[~~Medical Gases~~\|OXYGEN]] @ 100% via BVM.		:If bronchospasm worsens despite treatment, respiratory failure is imminent, or patient exhibits with an altered mental status, perform endotracheal intubation and ventilate with [[Oxygen\|OXYGEN]] @ 100% via BVM.
	:		:

	====Age GREATER than 13 years:====		====Age GREATER than 13 years:====
	* Assist ventilations with BVM, 100% [[~~Medical Gases~~\|OXYGEN]] or Apply CPAP device as indicated.		* Assist ventilations with BVM, 100% [[Oxygen\|OXYGEN]] or Apply CPAP device as indicated.
	* [[Albuterol\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft or CPAP device. After second updraft of [[Albuterol\|ALBUTEROL]], consider [[Atrovent\|IPRATROPIUM BROMIDE (ATROVENT)]] .5 mg via updraft. [[Atrovent\|ATROVENT]] is not for use in CHF or Cardiac Asthma. Repeat as necessary while monitoring heart rate.		* [[Albuterol\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft or CPAP device. After second updraft of [[Albuterol\|ALBUTEROL]], consider [[Atrovent\|IPRATROPIUM BROMIDE (ATROVENT)]] .5 mg via updraft. [[Atrovent\|ATROVENT]] is not for use in CHF or Cardiac Asthma. Repeat as necessary while monitoring heart rate.
	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.

Treloars at 13:43, 24 April 2020

2020-04-24T13:43:48Z

← Older revision		Revision as of 13:43, 24 April 2020
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	* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
	** Administer [[~~Electrolytes~~\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.		** Administer [[Magnesium Sulfate\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.

	:'''If condition unimproved or patient exhibits acute hypoxia EPINEPHRINE may be administered: 1:1000 1mg/ml 0.3 - 0.5 mg IM.'''		:'''If condition unimproved or patient exhibits acute hypoxia EPINEPHRINE may be administered: 1:1000 1mg/ml 0.3 - 0.5 mg IM.'''

Treloars at 12:55, 24 April 2020

2020-04-24T12:55:47Z

Treloars at 12:47, 24 April 2020

2020-04-24T12:47:42Z

Treloars at 20:29, 22 April 2020

2020-04-22T20:29:16Z

← Older revision		Revision as of 20:29, 22 April 2020
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	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no or inadequate response to the above, or patient is extremely anxious, consider [[~~Anesthetics~~\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
	** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.		** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.
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	* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System		* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System
	* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	* * If no or inadequate response to the above, or patient is extremely anxious, consider [[~~Anesthetics~~\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose

	====Age LESS than 13 years: RAPID ONSET====		====Age LESS than 13 years: RAPID ONSET====

Treloars at 19:55, 22 April 2020

2020-04-22T19:55:28Z

← Older revision		Revision as of 19:55, 22 April 2020
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	* [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System.		* [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System.
	** May administer second dosage if dyspnea unimproved.		** May administer second dosage if dyspnea unimproved.
	* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[~~Adrenergics~~\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System		* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System
	* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose

	====Age LESS than 13 years: RAPID ONSET====		====Age LESS than 13 years: RAPID ONSET====
	* In patients with rapid onset respiratory compromise due to asthma or bronchospasm, [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System simultaneous with IM [[~~Adrenergics~~\|EPINEPHRINE]] 1:1000 (1mg/ml) every 10-15 minutes, refer to Handtevy System.		* In patients with rapid onset respiratory compromise due to asthma or bronchospasm, [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System simultaneous with IM [[Epinephrine\|EPINEPHRINE]] 1:1000 (1mg/ml) every 10-15 minutes, refer to Handtevy System.
	*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.		*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.
	*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.		*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.
	*If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		*If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	*'''In the event of impending respiratory arrest and imminent death, [[~~Adrenergics~~\|EPINEPHRINE]] may be administered IV or IM. (Dose for IV same as in cardiac arrest patient)'''		*'''In the event of impending respiratory arrest and imminent death, [[Epinephrine\|EPINEPHRINE]] may be administered IV or IM. (Dose for IV same as in cardiac arrest patient)'''

	[[Category:Respiratory\|0301]]		[[Category:Respiratory\|0301]]

Treloars: /* Age GREATER than 13 years: */

2019-02-11T15:19:14Z

Age GREATER than 13 years:

← Older revision		Revision as of 15:19, 11 February 2019
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	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no or inadequate response to the above or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above, or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
	** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.		** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.

Treloars: /* Age LESS than 13 years: SLOW ONSET */

2019-02-11T15:18:57Z

Age LESS than 13 years: SLOW ONSET

← Older revision		Revision as of 15:18, 11 February 2019
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	* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Adrenergics\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System		* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Adrenergics\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System
	* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	* If no response to the above, consider [[Anesthetics\|KETAMINE (KETALAR)]] 1 mg/kg IVP OR 2 mg/kg IM x 1 dose		* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose

	====Age LESS than 13 years: RAPID ONSET====		====Age LESS than 13 years: RAPID ONSET====

Treloars: /* Age GREATER than 13 years: */

2019-02-11T15:17:56Z

Age GREATER than 13 years:

← Older revision		Revision as of 15:17, 11 February 2019
Line 15:		Line 15:
	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no or inadequate response to the above ~~and~~ patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
	** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.		** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.

Treloars: /* Age GREATER than 13 years: */

2019-02-11T15:16:06Z

Age GREATER than 13 years:

← Older revision		Revision as of 15:16, 11 February 2019
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	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no response to the above, consider [[Anesthetics\|KETAMINE (KETALAR)]] 1 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above and patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
	** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.		** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.

← Older revision		Revision as of 20:29, 22 April 2020
Line 15:		Line 15:
	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no or inadequate response to the above, or patient is extremely anxious, consider [[~~Anesthetics~~\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
	** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.		** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.
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	* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System		* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System
	* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	* * If no or inadequate response to the above, or patient is extremely anxious, consider [[~~Anesthetics~~\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose

	====Age LESS than 13 years: RAPID ONSET====		====Age LESS than 13 years: RAPID ONSET====

← Older revision		Revision as of 19:55, 22 April 2020
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	* [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System.		* [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System.
	** May administer second dosage if dyspnea unimproved.		** May administer second dosage if dyspnea unimproved.
	* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[~~Adrenergics~~\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System		* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System
	* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		* If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose

	====Age LESS than 13 years: RAPID ONSET====		====Age LESS than 13 years: RAPID ONSET====
	* In patients with rapid onset respiratory compromise due to asthma or bronchospasm, [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System simultaneous with IM [[~~Adrenergics~~\|EPINEPHRINE]] 1:1000 (1mg/ml) every 10-15 minutes, refer to Handtevy System.		* In patients with rapid onset respiratory compromise due to asthma or bronchospasm, [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System simultaneous with IM [[Epinephrine\|EPINEPHRINE]] 1:1000 (1mg/ml) every 10-15 minutes, refer to Handtevy System.
	*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.		*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.
	*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.		*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.
	*If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		*If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	*'''In the event of impending respiratory arrest and imminent death, [[~~Adrenergics~~\|EPINEPHRINE]] may be administered IV or IM. (Dose for IV same as in cardiac arrest patient)'''		*'''In the event of impending respiratory arrest and imminent death, [[Epinephrine\|EPINEPHRINE]] may be administered IV or IM. (Dose for IV same as in cardiac arrest patient)'''

	[[Category:Respiratory\|0301]]		[[Category:Respiratory\|0301]]

← Older revision		Revision as of 15:19, 11 February 2019
Line 15:		Line 15:
	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Bronchodilators\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no or inadequate response to the above or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above, or patient is extremely anxious, consider [[Anesthetics\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
	** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.		** Administer [[Electrolytes\|MAGNESIUM SULFATE]] 2 gm IV in 100 ml NaCl via buretrol or secondary IV solution (piggyback), over 10-15 minutes.

← Older revision		Revision as of 12:55, 24 April 2020
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	* [[Albuterol\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft or CPAP device. After second updraft of [[Albuterol\|ALBUTEROL]], consider [[Atrovent\|IPRATROPIUM BROMIDE (ATROVENT)]] .5 mg via updraft. [[Atrovent\|ATROVENT]] is not for use in CHF or Cardiac Asthma. Repeat as necessary while monitoring heart rate.		* [[Albuterol\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft or CPAP device. After second updraft of [[Albuterol\|ALBUTEROL]], consider [[Atrovent\|IPRATROPIUM BROMIDE (ATROVENT)]] .5 mg via updraft. [[Atrovent\|ATROVENT]] is not for use in CHF or Cardiac Asthma. Repeat as necessary while monitoring heart rate.
	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[~~Corticosteroids~~\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Solu-Medrol\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
	* For deteriorating patients (if no renal disease or CHF is not suspected)		* For deteriorating patients (if no renal disease or CHF is not suspected)
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	** May administer second dosage if dyspnea unimproved.		** May administer second dosage if dyspnea unimproved.
	* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System		* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System
	* If the patient is not responding to the above interventions, administer [[~~Corticosteroids~~\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		* If the patient is not responding to the above interventions, administer [[Solu-Medrol\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* * If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose

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	*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.		*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.
	*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.		*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.
	*If the patient is not responding to the above interventions, administer [[~~Corticosteroids~~\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		*If the patient is not responding to the above interventions, administer [[Solu-Medrol\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.
	*'''In the event of impending respiratory arrest and imminent death, [[Epinephrine\|EPINEPHRINE]] may be administered IV or IM. (Dose for IV same as in cardiac arrest patient)'''		*'''In the event of impending respiratory arrest and imminent death, [[Epinephrine\|EPINEPHRINE]] may be administered IV or IM. (Dose for IV same as in cardiac arrest patient)'''

	[[Category:Respiratory\|0301]]		[[Category:Respiratory\|0301]]

← Older revision		Revision as of 12:47, 24 April 2020
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	====Age GREATER than 13 years:====		====Age GREATER than 13 years:====
	* Assist ventilations with BVM, 100% [[Medical Gases\|OXYGEN]] or Apply CPAP device as indicated.		* Assist ventilations with BVM, 100% [[Medical Gases\|OXYGEN]] or Apply CPAP device as indicated.
	* [[~~Bronchodilators~~\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft or CPAP device. After second updraft of [[~~Bronchodilators~~\|ALBUTEROL]], consider [[~~Bronchodilators~~\|IPRATROPIUM BROMIDE (ATROVENT)]] .5 mg via updraft. [[~~Bronchodilators~~\|ATROVENT]] is not for use in CHF or Cardiac Asthma. Repeat as necessary while monitoring heart rate.		* [[Albuterol\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft or CPAP device. After second updraft of [[Albuterol\|ALBUTEROL]], consider [[Atrovent\|IPRATROPIUM BROMIDE (ATROVENT)]] .5 mg via updraft. [[Atrovent\|ATROVENT]] is not for use in CHF or Cardiac Asthma. Repeat as necessary while monitoring heart rate.
	* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[~~Bronchodilators~~\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.		* If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] 1.25mg nebulized via updraft.
	* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.		* Administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg IVP once the breathing treatment has been initiated.
	* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose		* If no or inadequate response to the above, or patient is extremely anxious, consider [[Ketamine\|KETAMINE (KETALAR)]] 0.5 mg/kg IVP OR 2 mg/kg IM x 1 dose
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	====Age LESS than 13 years: SLOW ONSET====		====Age LESS than 13 years: SLOW ONSET====
	* [[~~Bronchodilators~~\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System.		* [[Albuterol\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System.
	** May administer second dosage if dyspnea unimproved.		** May administer second dosage if dyspnea unimproved.
	* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System		* If patient exhibits acute dyspnea, as evidenced by AMS, administer [[Epinephrine\|EPINEPHRINE 1:1000]] 1mg/ml refer to Handtevy System
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	====Age LESS than 13 years: RAPID ONSET====		====Age LESS than 13 years: RAPID ONSET====
	* In patients with rapid onset respiratory compromise due to asthma or bronchospasm, [[~~Bronchodilators~~\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System simultaneous with IM [[Epinephrine\|EPINEPHRINE]] 1:1000 (1mg/ml) every 10-15 minutes, refer to Handtevy System.		* In patients with rapid onset respiratory compromise due to asthma or bronchospasm, [[Albuterol\|ALBUTEROL (PROVENTIL)]] refer to Handtevy System simultaneous with IM [[Epinephrine\|EPINEPHRINE]] 1:1000 (1mg/ml) every 10-15 minutes, refer to Handtevy System.
	*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[~~Bronchodilators~~\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.		*If the Pt has had multiple updrafts or had previously used their own Albuterol inhaler or nebulized treatment and have not had relief. Consider [[Xopenex\|XOPENEX (LEVALBUTEROL)]] nebulized via updraft refer to Handtevy System.
	*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.		*Monitor heart rate. Continue therapy with heart rates <180-200 ages up to 6 years, <150-180 ages 6-18 years. Updrafts may need to be continuous.
	*If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.		*If the patient is not responding to the above interventions, administer [[Corticosteroids\|METHYLPREDNISOLONE (SOLU-MEDROL)]], refer to Handtevy System.