Respiratory distress - Revision history

JenniferH at 12:37, 20 November 2020

2020-11-20T12:37:37Z

← Older revision		Revision as of 12:37, 20 November 2020
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	* Start nebulized racemic epinephrine neb		* Start nebulized racemic epinephrine neb
	* Give [[#Emergency Medications Available in the Village\|Dexamethasone]] by least invasive method possible		* Give [[#Emergency Medications Available in the Village\|Dexamethasone]] by least invasive method possible
			* Follow [[Pediatric Stridor\|stridor guidelines]] for ongoing management

	* Follow [[~~Pediatric Stridor\|stridor guidelines~~]] ~~for ongoing management~~
			[[Emergency RMT Scenarios and Responses]]

JenniferH: /* Stridor at Rest */

2020-03-29T00:49:41Z

Stridor at Rest

← Older revision		Revision as of 00:49, 29 March 2020
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	* Do NOT give albuterol; this can worsen croup		* Do NOT give albuterol; this can worsen croup
	* May give NS neb		* May give NS neb
	''[[~~Medevac Activation – Village to Bethel~~\|Activate a medevac]] immediately if patient develops signs or symptoms of severe croup or impending airway obstruction: drooling, lethargy, tripod position, marked retractions, tachycardia, cyanosis or pallor''		''[[media:Medevac_village_to_Bethel.pdf\|Activate a medevac]] immediately if patient develops signs or symptoms of severe croup or impending airway obstruction: drooling, lethargy, tripod position, marked retractions, tachycardia, cyanosis or pallor''
	* Start nebulized racemic epinephrine neb		* Start nebulized racemic epinephrine neb
	* Give [[#Emergency Medications Available in the Village\|Dexamethasone]] by least invasive method possible		* Give [[#Emergency Medications Available in the Village\|Dexamethasone]] by least invasive method possible

	* Follow [[Pediatric Stridor\|stridor guidelines]] for ongoing management		* Follow [[Pediatric Stridor\|stridor guidelines]] for ongoing management

JenniferH at 00:49, 29 March 2020

2020-03-29T00:49:18Z

← Older revision		Revision as of 00:49, 29 March 2020
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	* Consider close monitoring and possibly regular flight to Bethel		* Consider close monitoring and possibly regular flight to Bethel
	OR		OR
	* [[~~Medevac Activation – Village to Bethel~~\|Activate medevac]] if not improving		* [[media:Medevac_village_to_Bethel.pdf\|Activate medevac]] if not improving
	* VTC video monitoring if able		* VTC video monitoring if able
	* Increase nasal cannula O2 to 3-5 L as needed		* Increase nasal cannula O2 to 3-5 L as needed

JenniferH at 01:08, 31 August 2019

2019-08-31T01:08:30Z

← Older revision		Revision as of 01:08, 31 August 2019
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			[[image:All Emergency RMT.png\|750px]]

			[[media:pediatric critical care guide.pdf\|Pediatric Critical Care Guide]]
			-----
	[[add epi nebs]]		[[add epi nebs]]

JenniferH: Created page with "add epi nebs ==Adult== While assuring that the patient has sufficient supplemental O2 available in the clinic, inquire if he/she normally has Home O2, is an Expected Ho..."

2019-08-25T22:59:25Z

Created page with "add epi nebs ==Adult== While assuring that the patient has sufficient supplemental O2 available in the clinic, inquire if he/she normally has Home O2, is an Expected Ho..."

New page

[[add epi nebs]]

==Adult==

While assuring that the patient has sufficient supplemental O2 available in the clinic, inquire if he/she normally has Home O2, is an Expected Home Death or Palliation patient to better meet both the needs and planned desires of this patient.
Once full treatment of the patient is established, at least one trial of a nebulized bronchodilator with clinical progression of treatment as is indicated. Consider PO prednisone 40-60 mg x1 for broncho-constricted adult patients. Also consider medevac if after a trial of treatment, spO2 remains <90% or moderate to severe respiratory distress persists.

==Peds==

===Wheezing===
* Give Two back-to-back albuterol nebs
* O2 administered –preferably with NC, but blow by ok to start with
* If patient is febrile, give Tylenol and/or Motrin
* Find out who else is helping the CHAs, where the patient is and patient’s name and DOB
* Make sure the CHA calls for at least two more people to help.
* Move patient to clinic if they are at home or another site
* Make sure bag and good fitting mask is available
* Get patient information to look up past history medications etc
* Frequent reassessment and keep good documentation of times and interventions
* If patient improves with these interventions then reassess O2 requirement, RR and WOB.
* Consider close monitoring and possibly regular flight to Bethel
OR
* [[Medevac Activation – Village to Bethel|Activate medevac]] if not improving
* VTC video monitoring if able
* Increase nasal cannula O2 to 3-5 L as needed
* Frequent nebs or continuous Albuterol if required
* Try Atrovent nebs or racemic or nebulized epinephrine (IV solution)
* Call peds or a pediatric partner for help
* Consider prednisone 2mg/kg of crushed tablet in liquid/pudding or syrup.

===Stridor at Rest===
'''Remember Supportive Measures'''
* Keep child upright
* May take child outside for cool air
* Minimize invasive measures – keep child CALM!
* Do NOT give albuterol; this can worsen croup
* May give NS neb
''[[Medevac Activation – Village to Bethel|Activate a medevac]] immediately if patient develops signs or symptoms of severe croup or impending airway obstruction: drooling, lethargy, tripod position, marked retractions, tachycardia, cyanosis or pallor''
* Start nebulized racemic epinephrine neb
* Give [[#Emergency Medications Available in the Village|Dexamethasone]] by least invasive method possible

* Follow [[Pediatric Stridor|stridor guidelines]] for ongoing management