Page 99 - PJ MED OPS Handbook 8th Ed

Bronchitis/Pneumonia

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

Signs and Symptoms:
1. Fever
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. Moxifloxacin (Avelox) 400mg PO daily for 7 days
2. If unable to tolerate PO intake, ertapenem (Invanz) 1g IV/IM
3. Albuterol (Ventolin) by metered dose inhaler 2–4 puffs q4–6hr
4. If cough persists despite albuterol treatment, administer dexamethasone (Decadron) 10mg
PO/IM/IV.
5. Treat per Pain Management Protocol.
6. If febrile, acetaminophen 1g PO q6hr
7. Pulse oximetry monitoring
8. Oxygen PRN
9. Maintain hydration
10. 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.

Chapter 8. Tactical Medical Emergency Protocols (TMEPs) n 97