Indications: Respiratory distress and suspect bronchoconstriction.
Salubtamol: For patients weighing < 25kg administer up to 600mcg (6 puffs – 1 puff every 4 breaths) via MDI or 2.5mg via nebulizer every 5 to 15 minutes to a maximum of 3 doses.
For patients weighing ≥ 25kg administer at least 800mcg (8 puffs – 1 puff every 4 breaths) via MDI or 5mg via nebulizer every 5 to 15 minutes to a maximum of 3 doses.
Epinephrine: If the patient requires ventilations to be supported by BVM then administer 1 dose only of 1:1000 epinephrine IM 0.01mg/kg (rounded to the nearest 0.05mg) to a maximum dose of 0.5mg.
Pediatric Autoinjectors may be used for patients weighing ≥ 10kg but < 25kg.
Adult Autoinjectors may be used for patients weighing ≥ 25kg.
Mandatory Patch Point: If the patient weighs < 10kg then patch to BHP for authorization to use pediatric autoinjector.
Clinical Considerations: If the patient is apnoeic then epinephrine should be the first medication administered.
Salubtamol MDI may be administered subsequently using a BVM MDI adapter.
Nebulisation is contra-indicated in patients with a known or suspected fever or if they reside in a facility where there is a declared respiratory outbreak.