Albuterol should NOT be continued if the patient does not respond to test dose.
Perform Intervention Score before and after each treatment
|If responsive to albuterol test dose, may continue:
||Frequency of every 1-4 hours as needed
||Frequency of every 2-6 hours as needed
- α and β adrenergic agonist
- Consider use in patients with increasing severe respiratory distress
- Requires MD order/bedside assessment for administration
- Perform Intervention Score before and after each treatment
|High Flow Nasal Cannula
- Provides warmed, humidified air with adjustable oxygen concentration
- Reduces WOB
- Use in patients increasing WOB on the escalation pathway.
- HFNC may be initiated on any inpatient unit for one hour
- Patients who improve on HFNC may remain on 8S or 7W MHT:
- if oxygen flow setting is acceptable
- consult ICU if respiratory status is deteriorating
- Patients requiring High Flow Nasal Cannula on any other floor must be transferred to ICU
- Do NOT prescribe antibiotics without evidence of bacterial infection:
- Bacterial superinfections are uncommon in this age group.
- Prescribe antibiotics only when there is a specific secondary infection
- Regular administration of nebulized hypertonic (3%) saline to inpatients has been shown to shorten length of stay by one day
- Benefit comes with regular use every 6-8 hours for the entire hospitalization
- Consider initiating a hypertonic saline regimen (standing every 6-8 hours) in children with a prolonged hospital stay or those not showing improvement over the first 48 hours of admission.