ED Pathway for Evaluation/Treatment of Children with Asthma

Triage - Respiratory Distress

Respiratory Distress

1 Critical 2 Acute 3 Urgent 4 Urgent 5 Non-Urgent
  • Severe wheezing/stridor with:

    • Severe tachypnea
    • Bradypnea/apnea
    • Severe retractions
    • Grunting respirations
    • Decreased muscle tone
    • Lethargy
  • Absent breath sounds

  • Agonal respirations

  • Pulse oximetry < 90%

  • Wheezing/stridor with moderate:

    • Increased WOB
    • Nasal flaring
    • Tachypnea
    • Retractions
    • Prolonged expiration
    • Intermittent grunt
  • Decreased aeration with moderate tachypnea and WOB

  • Pulse oximetry < 92%

  • Stridor at rest

  • Asthmatic with Hx of intubation

  • Wheezing/Stridor with mild:

    • Increased WOB
    • Tachypnea
    • Retractions
  • Wheezing with minimal:

    • WOB
    • Tachypnea
    • Retractions
  • Pulse oximetry > 95%

  • Hx of neb within the hour