Raleigh General Hospital
Authorization is hereby given to dispense the generic equivalent unless otherwise indicated by the physician
Physician’s Order and Signature
Pediatric Medical Emergency Treatment Protocol
Date
Time
Nursing Care:
Vital Signs initially and as indicated
Capilary Refill initially and as indicated
Initiate continuous Cardiac Monitoring; Run rhythm strip
Maintain and/or establish peripheral IV access
STAT fingerstick Blood Glucose for decreased level of consciousness. Repeat in 30 minutes.
Corroborate blood glucose with serum glucose if less than 50mg/dl or greater than 300mg/dl
Call attending physician for IV antibiotic order if infectious process is suspected.
Notify Attending Physician of Patient Condition and Interventions Taken
Medications:
http://www.uptodate.com/contents/croup-approach-tomanagement?source=search_result&search=pediatric+medical+emergency+treatment&selectedTitle=6%7E150
Dextrose 10% solution 2ml per kg IV push for blood glucose less than 50mg/dl
Naloxone (Narcan) 0.1mg/kg up to 2mg MAXIMUM IV ONCE as needed for respiratory
depression with suspected narcotic overdose.
Racemic EPINEPHrine 0.05ml/kg by nebulizer, not to exceed 0.5ml in 3ml NS ONCE for
respiratory stridor/croup
Albuterol 2.5mg/3ml via nebulizer ONCE for respiratory distress
Respiratory Orders:
Clear and maintain airway (reposition to maintain open airway: head of bed @30 degrees, head
midline, if not contraindicated)
If airway compromised, may place oral airway to increase ventilation.
Oral-/naso-pharyngeal or nasotracheal suction PRN to maintain clear airway.
O2 at 2 liters per minute via nasal cannula (by mask for infants/small children)
Titrate oxygen to keep saturation greater than 92%
Assist ventilation as needed with non-invasive positive pressure ventilation via Bag-Valve-Mask
CPAP if indicated: Titrate to maintain O2 of 92% or greater
Laboratory:
STAT ABG for suspected respiratory distress or continued O2 saturation less than 92%
Imaging:
STAT portable chest x-ray with STAT reading for respiratory distress
STAT 2 view of soft tissue of neck
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Physician’s Signature ____________________________________________ Date:______________ Time: _______________
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Physician*s Order and Signature