ValleyProtocolBook

The Valley Hospital Emergency Services

14

Standing Orders / Communications Failure Orders

(b) If patient continues to seizure, and the seizure is atraumatic in nature, administer Normal Saline 20 mL/kg via vascular access.

(c) Provide airway management as required by patient’s clinical condition; Refer to the Standing Orders and Communications Failure Orders for pediatric advanced airway.

8.41-8.10 Standing orders for pediatric allergic reaction and/or anaphylaxis

(a) The following standing orders are authorized in the event a pediatric patient presents with an allergic reaction and/or anaphylaxis:

a. Assess and secure the airway;

b. Administer oxygen therapy as patient condition indicates;

c. Maintain normal body temperature;

d. Administer Epinephrine 0.01 mg/kg (0.01 ml/kg) of a 1:1,000 solution to a maximum of 0.3 mg IM;

e. If the patient is wheezing, administer Albuterol 2.5 mg via nebulizer;

f. Establish vascular access with normal saline solution at a KVO rate;

g. If patient remains hemodynamically unstable, administer a rapid fluid bolus of normal saline solution at a dose of 20 ml/kg via vascular access;

h. If no improvement, administer Diphenhydramine hydrochloride at a dose of 1 mg/kg (to a maximum dose of 50 mg) slowly via vascular access; and

i. Contact medical command.

Communications Failure Orders for pediatric allergic/reaction and/or anaphylaxis

(a) The following Communications Failure Orders are authorized in the event that a pediatric patient presents with signs of generalized allergic findings such as urticaria without signs of acute significant respiratory distress and/or profound hypotension (systolic blood pressure less than or equal to (70+[2*Age]) mmHg)

a. Administer Methylprednisolone Sodium Succinate 2 mg/kg up to 125 mg or Dexamethasone Sodium Phosphate 0.7 mg/kg up to 10 mg IV/IO over one to two minutes.