Bronchiolitis Oral/Enteral Feeding Guidance, Emergency Department and Inpatient – Severe Respiratory Distress and not Stable for Oral/enteral Feeding

Bronchiolitis Oral/Enteral Feeding Guidance Clinical Pathway — Emergency Department and Inpatient

Patient with Severe Respiratory Distress and Not Stable for Oral/Enteral Feeding

  • Mental Status: Sleepy, lethargic or inconsolable
  • Severe respiratory status without improvement on high flow
  • Escalating treatments (increasing high flow NC settings, increasing need for suctioning, NIPPV, etc.)
  • Any patient going to an ICU

Baseline Assessment and Pathway Status Determination

The highest rating in any of the categories below dictates the patient's starting position on the pathway. A severe rating in any category would indicate a starting position in the Severe classification. All Moderate assessments, or a mix of Mild and Moderate would indicate a starting position in the Moderate classification. When in doubt, err on the side of classifying a patient as more severe.

  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
Mental Status Baseline Fussy or anxious Lethargic or inconsolable
Oxygen Requirement None* Any Any
Suctioning Bulb Wall/Bulb Wall

*Any need for supplemental oxygen precludes Mild classification