Protocol 2-770 - Respiratory Distress

CMH EMS & MIH Protocols

EMD:

• No specific protocol.

EMR:

• Oxygen to maintain SpO2 between 88-92%.
• Consider moving patient to a cold air environment.
• Apply cardiac monitor limb leads.

EMT:

• Ensure completion of applicable items above.
• Assume respiratory distress with unknown cause is a STEMI: Obtain a 12-Lead ECG within 10 minutes of patient contact.
• Assist ALS with Capnography.

• Adult:	Pediatric:
  Consider assisting ALS with a trial of CPAP.	NA

AEMT:

• Ensure completion of applicable items above.
• Consider IV NS/LR in AC (left is preferred) with pigtail extension with 18 ga or greater.
• Consider Albuterol 2.5 mg in NS 3 ml Nebulized.

• Adult:	Pediatric:
  Consider Duoneb 3 ml Nebulized (max 1 dose). HR greater than 110: Consider Xopenex 0.63-1.25 mg Nebulized. Consider Epinephrine 1:1,000 0.3-0.5 mg IM/SQ. Caution when greater than 55 yr old with cardiac history.	Consider Duoneb 1.5 ml Nebulized (max 1 dose). Greater than 6 yr old: Consider Xopenex 0.31-0.63 mg Nebulized.

RN:

• Ensure completion of all applicable items above.
• Consider IO NS/LR.
• Consider 12-Lead ECG.

• Adult:

  Pediatric:

  Consider Decadron 16 mg Nebulized. Consider Solu-Medrol 125 mg IV/IO/IM. Consider Magnesium Sulfate 2 g IV/IO in NS over 15-20 min.

  Croup or epiglottitis: Consider Racemic Epinephrine 0.5 ml with 3 ml NS Nebulized. In the absence of Racemic Epinephrine, Epinephrine 1:1,000 0.5 ml/kg (max 5 ml) may be Nebulized. Click "calculate" to get dose. Consider Decadron 4-8 mg Nebulized. Consider contacting MEDICAL CONTROL: Consider Solu-Medrol 1-2 mg/kg IV/IO/IM. Click "calculate" to get dose. Consider Magnesium Sulfate 25-50 mg/kg IV/IO in NS over 15-20 min.

• CHF or pulmonary edema: Refer to Protocol 2-726 - Pulmonary Edema.

Medic:

• Ensure completion of all applicable items above.
• Consider Protocol 2-044 - Airway: RSI.

CP:

• Ensure completion of all applicable items above.
• Refer to MIH Protocol 4-458 - Chronic Respiratory Disease Management.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.