Diet : ( if in distress ) : NPO
N/S: routine
1. CBC diff
2. Electrolyte
3. BUN & Creatinine
4. U/A
5. CXR
6. pulse oximetry
7. O2 ( if O2sat < 90% )
8. ABG
9. IV maintainance
10. ( if fever ) : Acetaminophen 16mg /kg/dose PO q 4 6 h
11. Nasal drop NACL : 2-4 drops q 4-6 h + NACL .suction
12. ( if wheeze ): ventoline 0.15 mg/kg (= 2.5 mg ) with nebulizer q 20 min then q 2h – 4h -6h
13. ( if severe wheeze & tachypnea ) : Hydrocortisone 5 mg/kg/dose IV sat then 2 mg / kg / dose IV QID
14. ( if cough ) : SYR Ketotifen 2.5 – 5 cc , or Tab Ketotifen 1 mg ) BID
15. ( if GERD ) : Omeprazole 1 mg / kg / dose BID
16. Antibiotics : Clindamycin 10 mg / kg / dose IV QID
( IF suspected to GI aspiration ) : + ceftriaxone 75mg / kg / day IV 2 div doses or cefotaxime 50 mg / kg / dose TDS – QID
( IF resistant ) : imipnem 20 mg / kg / dose QID or Meropnem 20 mg / kg / dose TDS voncomycin 15 mg / kg / dose QID
17. Suction & chest physiotherapy
OPD :
1. cap clindamycin 150 ( or SYR clindamycin 75/5 ml ) : 10 mg / kg / dose QID
2. SYR ketotifen 1.5-5 cc BID
3. Cap Omeprazole : 1 mg / kg / dose BID ( before meals )
4. Nasal drop nacl : 2-4 drops q 4-6 h
5. ( if fever ) : Acetaminophen 15 mg / kg / dose QID