Inpatient Pathway for Treatment of the Child with Bronchiolitis

Albuterol Trial

Before Albuterol Trial

Albuterol Trial

Weight (kg) Intermittent Nebulization
(0.5% solution (5 mg/mL)
MDI (90 mcg/puff)
< 5 1.25 mg (0.25 mL) Per physician's discretion
≥ 5 2.5 mg (0.5 mL) 2-4 puffs
NOTE: Albuterol should NOT be continued if the patient does not respond to nebulized test dose.
If responsive to albuterol test dose, may continue:
  MDI Frequency of every 1-4 hours as needed
  Intermittent nebulization Frequency of every 2-6 hours as needed

Use the Response to Intervention Score below to assess children after each intervention.

    Mild (0) Moderate (1) Severe (2)
RR < 3 months 30-60 61-80 > 80
3 - < 12 months 25-50 51-70 > 70
1y – 2y 20-40 41-60 >60
WOB None or mild Intercostal retractions Nasal flaring, grunting, head bobbing
Mental Status Baseline Fussy or anxious Lethargic or inconsolable