HomeMy WebLinkAboutSOG 203.01C REVISED 8-2016_Resp. Distress (Non-Trauma)203.01 C - Respiratory Distress (Non -Traumatic)
Effective. 5/1/2001
Revised: 8/5/2016
Replaces: 203.01 A
I. Goal
The goal of this policy is to define the standard of care for any patient presenting with
non-traumatic respiratory distress.
II. Protocol
A. Institute protocol " 203.O1A" for all patients.
B. Monitor respiratory efforts closely.
1. Listen to lung sounds.
2. Use BVM to ventilate IF patient is unconscious and respiratory rate is less
than 12/minute or greater than 40/minute.
C. Monitor vital signs, utilize pulse -oximetry, and check blood glucose level. Repeat
every 5-10 minutes.
D. Consider Ipratropium Bromide (Atrovent)
by nebulizer mask when patient meets following criteria:
1. history of asthma/COPD
2. wheezing or decreased breath sounds
3. adult dosage: 0.5mg / 2.5 ml (8 years of age and older) was 13years of age
E. Contraindications:
1. pulmonary edema (swelling of feet or ankles)
2. B/P higher than 200
3. history of taking Lasix
4. history of HTN (hypertension)
5. age: younger than 8
Endorsements:
D"1044 kAVA•, 04.11,,, MD R/S/2016
Darioush Kavaspour, MD Date Signed
Medical Director BEMSBFRS
III. Notes
A. DO NOT use a paper bag or a non-rebreather with low flow oxygen for
hyperventilated patients.
B. Ipratropium Bromide (Atrovent)
PHYSIOLOGICAL ACTIONS
Parasympatholytic Bronchodilator
Anticholinergic
Selectively blocks systemic responses to
acetylcholine (Ach). Acts directly on the smooth
muscle and decreases secretions. Reduces the
vagal mediated reflex bronchospasm caused by
inhaled irritants.
Blocks acetylcholine -induced stimulation of guanyl
cyclase and reduces formation of cyclic guanosine
monophosphate (cGMP), a mediator of
bronchoconstriction.
THERAPEUTIC EFFECTS
Bronchodilation
Relaxes smooth muscles of bronchi and bronchioles
PREGNANCY CATEGORY
B
INDICATIONS
Obstructive Airway Disease
Reactive Airway Disease
CONTRAINDICATIONS
Narrow -angle Glaucoma
Hypersensitivity to Atropine
DOSAGE
Adult: 8+
I ratro ium bromide
500 mcg (0.02%) in 3 mL saline mixed with albuterol
2.5 mg in 3 mL NS nebulized
ROUTE
Nebulized inhalation by Small Volume Nebulizer
(SVN)
SIDE EFFECTS
Headache, dizziness
Dry mouth, cough, dries secretions, hoarseness
Blurred vision or other vision changes.
Nausea, upset stomach
SPECIAL NOTES
Peak 1.5 — 2 hours, duration 4 — 6 hours.
Medical Director's Initials P. k1
Date 8/5/2016
SOG 203.01 C — Respiratory Distress (Non -Traumatic) Page 2 of 2