Despite being a whopping three pages, the protocol for Pediatric Asthma/Wheezing is largely the same as its adult counterpart, just without considerations for COPD since it’s kind hard to rack up a 50-pack-year history of smoking before the age of 15 (although who knows how this kid is doing nowadays? https://www.youtube.com/watch?v=x4c_wI6kQyE ).
Otherwise, as in the protocol for adults, CFRs will assist with home albuterol, BLS will give up to one albuterol nebulizer and an injection of IM epinephrine, and ALS will continue albuterol and add ipratropium and steroids as needed. Medical Control Options include additional doses of epinephrine or albuterol as indicated (note that Standing Orders allow for a maximum of 3 albuterol nebs for kids, versus continuous for adults). Pediatric dosing considerations are highlighted throughout this protocol, both for epinephrine and for dexamethasone; methylprednisolone, as well as magnesium sulfate for that matter, are reserved for adults).
Hope the new protocol format makes sense! Keep brushing up at www.nycremsco.org and with the protocol binder!
Dave