Inpatient Pathway for Treatment of the Child with Bronchiolitis

Further Diagnostic Testing

Chest X-ray X-rays are not routinely recommended
Consider if clinical picture is not consistent with typical bronchiolitis:
  • Clinical course suggests super infection
  • New fever late in the disease process
  • Severe disease / toxic appearance with a lack of upper respiratory symptoms
Viral Testing Viral testing is not routinely recommended
Consider testing if:
  • The diagnosis is in question
  • Prolonged fever
  • When there is a high clinical suspicion of flu and
    • The child is being seen within the window when antivirals will be effective (for patients to be discharged)
    • The child is being admitted
Pertussis PCR Pertussis Testing is not routinely recommended
Consider if:
  • History of apnea or prolonged paroxysmal cough
  • Known exposure
  • Unimmunized or only partially immunized
  • Significant pertussis activity in the community