Inpatient Pathway for Treatment of the Child with Bronchiolitis
Related Pathway:
ED Bronchiolitis
Pathway
SUPPORTIVE CARE
Suction
Hydration, nutrition
Supplemental oxygen
Pulse oximetry
Fever Management
Additional Treatment Considerations Further Diagnostic Testing
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Initial Work-up
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Severe
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Moderate
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Mild
  • Q 1h assessments
  • Nasal suctioning - Wall
  • Continuous O2 monitoring
  • CR Monitoring
  • IV fluids/NG tube feeds/PO
    as tolerated
  • Use of HFNC automatically
    classifies patient as Severe
  • Q 2h assessments
  • Nasal suctioning – Bulb/Wall
  • Intermittent O2 monitoring
  • IV fluids/NG tube feeds/PO
    as tolerated
  • Q 4 h assessments
  • Nasal suctioning – Bulb
  • Intermittent O2 monitoring
  • Resume normal feeds
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ESCALATION
  • Consider :
  • Racemic epinephrine
  • CAT Call
  • Make child NPO

Response to Intervention Score

  Mild (0)Moderate (1)Severe (2)
RR< 3 months30-6061-80> 80
3 - < 12 months25-5051-70> 70
1y – 2y20-4041-60>60
WOBNone or mildIntercostal retractionsNasal flaring, grunting, head bobbing
Mental StatusBaselineFussy or anxiousLethargic or inconsolable
Posted : November 2013
Authors : M. Dunn, MD; J. Zorc, MD; J. Kreindler, MD; L. Tyler, RRT; E. Pete Devon, MD; M. McCloskey,
RN; V. Madrigal, MD; L. McAndrew, MD; A. Barnes, MD; A. Gahman, RN; K. Leach, RN, R. Keren, MD