Bronchiolitis — Sample Bronchiolitis Pathway Patient Progression — Clinical Pathway: Emergency and Inpatient

Sample Bronchiolitis Pathway Patient Progression

Time	2300	2400	0100	0200	0300	0400	0500	0600	0800
Patient Pathway Assessment	Severe	Severe	Severe	Moderate	Moderate	Moderate	Moderate	Moderate	Moderate
Patient Pathway Assessment	Severe	Severe	Severe	Severe	Severe	Severe	Severe	Moderate	Moderate
Assessment with score CRM	CRM Cont. Pox	CRM Cont. Pox	CRM Cont. Pox	CRM Cont. Pox	Discontinue CRM and Cont. POX	Spot check POX	Spot check POX	Spot check POX	Spot check POX
Intervention Assess in 10 minutes if intervention was due to escalation of care	Wall suction/neb treatment / oxygen as ordered	Wall suction/neb treatment / oxygen as ordered	Wall suction/neb treatment / oxygen as ordered	Wall suction/neb treatment / oxygen as ordered	Wall suction/neb treatment / oxygen as ordered	Wall suction/neb treatment / oxygen as ordered	Wall or bulb suction/neb treatment / Oxygen as ordered	Wall or bulb suction/neb treatment / Oxygen as ordered Change Orders	Wall or bulb suction/neb treatment / Oxygen as ordered

Time	1000	1200	1400	1600	1800	2000	2200	2400	0400
Patient Pathway Assessment	Moderate	Moderate	Moderate	Moderate	Moderate	Mild	Mild	Mild	Mild
Patient Pathway Assessment	Moderate	Moderate	Moderate	Moderate	Moderate	Moderate	Moderate	Mild	Mild
Assessment with score		Spot check POX		Spot check POX		Spot check POX		Spot check POX
Intervention Assess in 10 minutes if intervention was due to escalation of care	Wall or bulb suction/neb treatment / oxygen as ordered	Wall or bulb suction/neb treatment / oxygen as ordered	Wall or bulb suction/neb treatment / oxygen as ordered	Wall or bulb suction/neb treatment / oxygen as ordered	Wall or bulb suction/neb treatment / oxygen as ordered	Bulb suction prn	Bulb suction prn	Bulb suction prn Change Orders	Bulb suction prn

Discharge Criteria:

Pulse ox ≥ 90% in room air for 3 consecutive checks 4 hrs apart
Feeding adequately to stay hydrated
No wall suction for ≥ 8 hrs

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.