Key cautions & base contact

IM asthma epinephrine requires the base-order pathway; anaphylaxis has its own standing-order criteria.
Do not use pediatric CPAP below age 8 or above the pediatric pressure limit.

First assessment

Assess appearance, work of breathing, and circulation, then support the airway and ventilation as needed.
When SpO₂ is below 95%, give high-flow mask oxygen or nasal cannula/direct blow-by at 6 L/min as tolerated.
Check for an allergic trigger, upper-airway obstruction, wheeze, barking cough, and poor perfusion.

For suspected asthma with wheeze: albuterol 5 mg in 6 mL by continuous nebulization as tolerated. If there is no improvement, consider a base-order request for IM epinephrine.
For possible anaphylaxis with upper-airway obstruction or respiratory distress: epinephrine 0.01 mg/kg IM of the 1 mg/mL preparation, maximum 0.5 mg, and the fuller SO-P-060 pathway.
CPAP requires an appropriate mask and the separate PR-120 criteria; the current procedure applies from age 8, with pediatric pressure no higher than 5 cm H₂O.

For recurrent barking-type cough, the source lists 3 mL normal saline by continuous nebulization as tolerated.
With poor perfusion, obtain IV/IO and give 20 mL/kg saline, maximum 250 mL, with base contact. May repeat twice for 3 total boluses.

Use ALS escort to the nearest appropriate ERC. Contact base, pediatric-capable preferred, if there is no response or status worsens.
310.00 also includes pediatric respiratory distress as a base-contact trigger. Record the child’s weight, respiratory findings, treatment, and response.
The I-20 newborn band lists a different albuterol amount from the general respiratory-order wording. Reconcile neonatal dosing with base rather than silently substituting a chart row.