Page 201 - ATP-P 11th Ed

BRONCHITIS / PNEUMONIA PROTOCOL

SPECIAL CONSIDERATIONS
1. Consider high altitude pulmonary edema (HAPE) at high altitudes.
2. Consider pulmonary embolism (PE) and pneumothorax (fever and productive
cough are atypical for these).

Signs and Symptoms
1. Fever SECTION 2
2. Productive cough, especially with dark yellow, red tinged, or greenish sputum
3. Chest pain
4. Rhonchi may be present and breath sounds may be decreased over the affected lung
5. Dyspnea may be present in severe cases
Management
1. Azithromycin (Zithromax ) 500mg PO first dose then 250mg daily for 4 days OR
®
moxifloxacin (Avelox ) 400mg PO daily for 7 days.
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2. If unable to tolerate PO intake, ertapenem (Invanz ) 1g IV/IM OR ceftriaxone
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(Rocephin ) 1g IV daily.
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3. Albuterol (Ventolin ) by metered dose inhaler 2–4 puffs q4–6hr
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4. Treat per Pain Management Protocol.
5. If febrile, acetaminophen 1g PO q6hr.
6. Pulse oximetry monitoring
7. Oxygen prn
8. If at high altitude, see Altitude Illness Protocol and treat for HAPE.
Disposition
1. Urgent evacuation for severe dyspnea or hypoxia.
2. Observation or Routine evacuation as necessary.

190 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 191