Entrapment/Traumatic Event - Pediatric Algorithm

What protocol is followed without a high suspicion of severe bone injury in entrapment?

Pediatric General Trauma protocol.

When is the airway protocol used in pediatric entrapment?

If indicated.

When is a fluid bolus considered with IV/IO access in pediatric entrapment?

If needed.

When is the cardiac monitor required in pediatric entrapment?

When safe to do.

What pain score qualifies for ketamine in pediatric entrapment?

Greater than 8.

What vital signs must be present for ketamine in pediatric entrapment?

Abnormal vital signs.

What GCS is required for ketamine in pediatric entrapment?

8 or greater.

What pain scales are used in pediatric entrapment?

The 1 to 10, FLACC, or FACES scale.

What protocols are used if severe pain criteria are not met in pediatric entrapment?

Pediatric General Trauma protocol and Pediatric Pain Management protocol.

What is the dose of ketamine for pediatric entrapment?

0.5 mg/kg.

How is ketamine administered for pediatric entrapment?

Slow IV push, IV/IO only.

How many times can ketamine be repeated in pediatric entrapment?

Once, if needed.

When can ketamine be repeated in pediatric entrapment?

5 minutes after the initial dose.

What is assessed and monitored after ketamine in pediatric entrapment?

Respiratory status.

Who provides oxygen in pediatric entrapment?

The ALS provider.

What is the minimum oxygen device in pediatric entrapment?

Nasal cannula.

When is sodium bicarbonate given in pediatric entrapment?

Suspicion of compartment syndrome or crush injury.

What is the dose of sodium bicarbonate for pediatric entrapment?

1 mEq/kg.

What is the max dose of sodium bicarbonate in pediatric entrapment?

50 mEq.

How is sodium bicarbonate administered in pediatric entrapment?

IV/IO.

When is TXA given in pediatric entrapment?

Suspicion of incompressible hemorrhage.

What is the dose of TXA for pediatric entrapment under 12 years old?

15 mg/kg.

What is the dose of TXA for pediatric entrapment over 12 years old?

1 gram.

How is TXA administered in pediatric entrapment?

IV/IO.

How long is TXA infused over in pediatric entrapment?

10 minutes.

How often is the patient reassessed after medication in pediatric entrapment?

Every 5 minutes following any medication dose by the ALS provider.

What protocol is used for a decrease in level of consciousness in entrapment?

Altered Mental Status protocol, if indicated.

What protocol is used for a decrease in respiratory status in entrapment?

Pediatric Airway Protocol, if indicated.

What is the final step in pediatric entrapment?

Transport.