4-7 PEDIATRIC NON-TRAUMATIC HYPOPERFUSION

EMR - Emergency Medical Responder

1. Establish patient responsiveness.
2. Assess the patient’s airway for patency, protective reflexes and the possible need for advanced airway management. Look for signs of airway obstruction and if present proceed as per airway obstruction protocol.
3. Open the airway via chin lift or modified jaw thrust.
4. Suction as necessary
5. Consider placing an oropharyngeal or nasopharyngeal airway adjunct if the airway cannot be maintained with positioning and the patient is unconscious.
6. Assess patient breathing, including mental status rate, auscultation, inspection, respiratory effort, adequacy of ventilation as indicated by chest rise and obtain a pulse oximetry reading.
7. If signs of respiratory arrest or respiratory failure with inadequate breathing are present, assist ventilation using a B-V-M device with 100% oxygen.
8. If breathing is adequate, place the child in a position of comfort and administer high-flow 100% oxygen as tolerated.
9. Assess circulation and perfusion.
10. Call for ALS intercept

EMT - Emergency Medical Technician  Perform/Confirm All Above Interventions

1. Apply ECG monitor & run strip if trained to do so, time allows and after all other interventions are completed.
2. Check blood glucose and if less than 60, treat according to pediatric hypoglycemia protocol
3. Initiate transport and Contact MEDICAL CONTROL to request ALS intercept.

AEMT – Advanced Emergency Medicine Tech   Perform/Confirm All Above Interventions

1. Establish vascular access and administer 20 mL/kg NS bolus. If IV access unlikely or cannot be obtained in 2 attempts in a child less than 6 initiate transport and request ALS intercept.
2. If evidence of poor perfusion persists, administer additional 20 mL/kg NS bolus.
3. Contact MEDICAL CONTROL for orders regarding ongoing rate of fluid administration.

Intermediate - Perform/Confirm All Above Interventions

1. Establish vascular access. If IV access unlikely or cannot be rapidly established consider IO placement.
2. Evaluate need for advanced airway management and ventilatory support.
3. Initiate transport.
4. Contact MEDICAL CONTROL for further orders.

Paramedic - Perform/Confirm All Above Interventions