ValleyProtocolBook
The Valley Hospital Emergency Services
21
Standing Orders / Communications Failure Orders
8.41-8.16 Standing orders for pediatric non-traumatic shock
(a) The following standing orders are authorized in the event that a pediatric patient presents with non-traumatic shock:
a. Assess and secure the airway;
b. Administer oxygen therapy as patient condition indicates;
c. Maintain normal body temperature;
d. Establish vascular access with normal saline solution at a KVO rate;
e. Administer a rapid fluid bolus of normal saline at a dose of 20 mL/kg;
f. Obtain a rapid glucose test. If blood glucose is less than 60:
i. For patients less than one month of age, administer 0.5 g/kg of a 10 percent dextrose solution via IV/IO;
ii. For patients greater than one month of age, administer 0.5 g/kg of a 25 percent dextrose solution via IV/IO.
iii. If unable to establish vascular access, administer Glucagon 0.1 mg/kg (0.1 ml/kg) to a maximum of 1 mg IM (1mg=1ml=1 unit);
g. If no change, administer a rapid fluid bolus of normal saline solution at a dose of 20 mL/kg; and
h. Contact medical command.
Communications Failure Orders pediatric non-traumatic shock
(a) If the patient has not improved, administer a rapid fluid bolus of normal saline at a dose of 20 mL/kg.
(b) If during the course of transport, patient requires intubation, refer to the Standing Orders and Communications Failure Orders for pediatric advanced airway.
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