RESPIRATORY DISTRESS (PED-CROUP)
DESIGNATION OF CONDITION
The most common age group affected is 1 to 3 years but this process can develop in any age patient. The onset is slow. Signs and symptoms are: hoarse voice, harsh “seal bark” cough, stridor upon inhalation, and high-pitched squeaking sounds may be present. In addition, other signs of respiratory distress may be present. Always consider the possibility of foreign body aspiration.
BASIC / AEMT
EMPHASIS ON PATIENT CARE
1. Airway management, adequate oxygenation
2. Primary Management - Assess ABC’s and manage as indicated.
3. Initiate transport to an appropriate medical facility. Consider ALS intercept.
4. Secondary Management - History, physical exam, vital signs
PARAMEDIC
1. Consider Nebulized EPINEPHRINE 1:1000 (0.5 mg.) Repeat as needed.
2. 4. Consider DEXAMETHASONE orally as alternative to Methylprednisolone. (Vial concentration 10 mg./1 ml.) Draw 0.6 mg./kg. (0.06 ml./kg.) from vial with TB (1 ml.) syringe. Remove needle and administer orally. (Vial concentration 20 mg./5 ml.) Dose is drawn in TB (1 ml) syringe without needle. 0.15 ml./kg. PO Maximum dose 10 mg. Concentration in vial should be confirmed;
3. Do not attempt to intubate if there is adequate air exchange. Intubation rarely needed
Intubate the patient only if the patient is 13 years or older and meets other intubation criteria.
DESIGNATION OF CONDITION
The most common age group affected is 1 to 3 years but this process can develop in any age patient. The onset is slow. Signs and symptoms are: hoarse voice, harsh “seal bark” cough, stridor upon inhalation, and high-pitched squeaking sounds may be present. In addition, other signs of respiratory distress may be present. Always consider the possibility of foreign body aspiration.
BASIC / AEMT
EMPHASIS ON PATIENT CARE
1. Airway management, adequate oxygenation
2. Primary Management - Assess ABC’s and manage as indicated.
3. Initiate transport to an appropriate medical facility. Consider ALS intercept.
4. Secondary Management - History, physical exam, vital signs
PARAMEDIC
1. Consider Nebulized EPINEPHRINE 1:1000 (0.5 mg.) Repeat as needed.
2. 4. Consider DEXAMETHASONE orally as alternative to Methylprednisolone. (Vial concentration 10 mg./1 ml.) Draw 0.6 mg./kg. (0.06 ml./kg.) from vial with TB (1 ml.) syringe. Remove needle and administer orally. (Vial concentration 20 mg./5 ml.) Dose is drawn in TB (1 ml) syringe without needle. 0.15 ml./kg. PO Maximum dose 10 mg. Concentration in vial should be confirmed;
3. Do not attempt to intubate if there is adequate air exchange. Intubation rarely needed
Intubate the patient only if the patient is 13 years or older and meets other intubation criteria.