[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-136927-105":59,"doc-detail-136927-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","emergency-department-bronchiolitis-algorithm","Emergency Department Bronchiolitis Algorithm","","Emergency Department bronchiolitis algorithm outlines inclusion and exclusion criteria for infants and provides a structured approach to classify respiratory distress as mild, moderate, or severe. It specifies supportive interventions including nasal suction, hydration optimization, oxygen thresholds, and continuous monitoring when needed. The guideline clarifies when to consider hypertonic saline, documents bronchodilator trials if performed, and discourages routine use of corticosteroids, imaging, viral testing, and antibiotics. It links clinical response to escalation for persistent severe distress and defines discharge criteria with follow-up planning.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/emergency-department-bronchiolitis-algorithm/136927/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/emergency-department-bronchiolitis-algorithm/136927.png","ImageObject",300,407,{"name":92,"@type":93},"Sage","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-08-22",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Which infants are included in this bronchiolitis algorithm?","Question",{"text":113,"@type":114},"Infants aged 1–24 months with a clinical impression of bronchiolitis are included.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What conditions exclude a patient from this guideline?",{"text":118,"@type":114},"Exclusions include prematurity (GA \u003C34 weeks and age \u003C6 months), chronic lung disease on baseline medications or oxygen, unrepaired or hemodynamically significant congenital heart disease, anatomic airway defects, neuromuscular disease, and immunodeficiency.",{"name":120,"@type":111,"acceptedAnswer":121},"What supportive care and escalation steps are recommended for moderate or severe distress?",{"text":122,"@type":114},"For moderate distress: nasal suction, spot-check pulse oximetry on room air with vitals, supplemental oxygen if persistently \u003C90%, consider IV fluids or NG feeds if oral intake is inadequate, and normal feeds as tolerated. For severe distress: nasal suction, supplemental oxygen if persistently \u003C90%, continuous monitors, IV fluids, and NPO pending respiratory support. If distress remains severe, escalate respiratory support (consider HFNC, CPAP, BiPAP) and urgently escalate for apnea, bradypnea, decreased responsiveness, diminished/absent breath sounds, poor perfusion, or hypoxemia despite supplemental oxygen.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},136927,1787395473,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":130,"read_time":24},687197207057,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","|  |  |\n| --- | --- |\n| \u003Cbr>Emergency Department Bronchiolitis\u003Cbr>Algorithm |  |\n| \u003Cbr>\u003Cbr>A. Inclusion Criteria\u003Cbr>• 1 – 24 months\u003Cbr>• Clinical impression bronchiolitis\u003Cbr>\u003Cbr>B. Exclusion Criteria\u003Cbr>• Prematurity (GA \u003C34 weeks and \u003C6 months of age)\u003Cbr>• Chronic lung disease requiring baseline medications or oxygen\u003Cbr>• Unrepaired congenital heart disease or hemodynamically significant cardiac disease requiring cardiac medications\u003Cbr>•Anatomic airway defects including those with recent repair\u003Cbr>• Neuromuscular disease\u003Cbr>• Immunodeficiency\u003Cbr>\u003Cbr>C. Respiratory Distress Classification\u003Cbr>• Mild: Accessory muscle use, mild indrawing of subcostaland intercostal muscles, mild tachypnea, no grunting\u003Cbr>• Moderate: accessory muscles use, moderate indrawing of subcostal and intercostal muscles, moderate tachypnea, occasional grunting\u003Cbr>• Severe: use of all accessory muscles, severe indrawing of subcostal and intercostal muscles, severe tachypnea, regular grunting\u003Cbr>\u003Cbr>D. Additional Considerations\u003Cbr>• Lapses in assessing suctioning need (>4h) may lead to increased length of stay\u003Cbr>• Repeated nasopharyngeal (“deep”) suctioning may lead to nasal edema and may be associated with increased length of stay\u003Cbr>• Bronchodilators are not routinely indicated. If a one-time albuterol trial is performed, indication and response should be documented.\u003Cbr>• Nebulized hypertonic saline can be considered in admitted children, especially if hospital course protracted.\u003Cbr>• Systemic corticosteroids, CXR, and/or viral testing are not routinely recommended.\u003Cbr>• Antibiotics are not routinely recommended unless there is evidence of or strong suspicion fora concurrent bacterial infection | \u003Cbr>YES\u003Cbr>\u003Cbr>\u003Cbr>NO\u003Cbr>\u003Cbr>Does the patient meet the bronchiolitis clinical care guideline criteria?(see Box A & B)\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>MODERATE\u003Cbr>• Nasal suction\u003Cbr>• Spot check pulse ox with vitals if on room air\u003Cbr>• Supplemental oxygen if persistently \u003C90%\u003Cbr>• Continuous monitors only if on oxygen\u003Cbr>• Normal feeds as tolerated\u003Cbr>• Consider IV fluids or NG feeds if PO intake inadequate (\u003C75% of maintenance needs) or increased respiratory distress with feeds\u003Cbr>\u003Cbr>SEVERE\u003Cbr>• Nasal suction\u003Cbr>• Supplemental oxygen if persistently \u003C90%\u003Cbr>• Continuous monitors\u003Cbr>• PIV/IV fluids\u003Cbr>• NPO pending respiratory support needs\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>• Initiate supportive care (high flow pause criteria):\u003Cbr>• Nasal suction\u003Cbr>• Soothe/swaddle\u003Cbr>• Anti-pyretic if febrile\u003Cbr>• Optimize hydration\u003Cbr>\u003Cbr>Discharge home with instructions & follow-up care or consider admission if not meeting discharge criteria\u003Cbr>\u003Cbr>Discharge Criteria\u003Cbr>• No oxygen need\u003Cbr>• Minimal respiratory distress\u003Cbr>• Able to maintain adequate oral intake\u003Cbr>• Follow-up care arranged\u003Cbr>• PEM/UC attending/fellow discretion\u003Cbr>\u003Cbr>Improvement?\u003Cbr>\u003Cbr>\u003Cbr>• See additional considerations (Box D)\u003Cbr>• If distress remains severe, escalate respiratory support (consider HFNC, CPAP, BiPAP)\u003Cbr>• Continue suctioning to nasopharynx, as needed, with assessment & documentation of clinical response\u003Cbr>• Supplemental oxygen if persistently \u003C90%\u003Cbr>• Consider immediate escalation of care for any of the following: apnea, bradypnea, decreased responsiveness, diminished/absent breath sounds, poor perfusion, hypoxemia despite supplemental oxygen\u003Cbr>• See additional considerations (Box D)\u003Cbr>• If distress remains severe, escalate respiratory support (consider HFNC, CPAP, BiPAP)\u003Cbr>• Continue suctioning to nasopharynx, as needed, with assessment & documentation of clinical response\u003Cbr>• Supplemental oxygen if persistently \u003C90%\u003Cbr>• Consider immediate escalation of care for any of the following: apnea, bradypnea, decreased responsiveness, diminished/absent breath sounds, poor perfusion, hypoxemia despite supplemental oxygen\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>Does the patient meet discharge criteria?\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>Admit\u003Cbr>\u003Cbr>NO\u003Cbr>\u003Cbr>YES\u003Cbr>NO\u003Cbr>|\n|  |  |\n| \u003Cbr>© Ann & Robert H. Lurie Children’s Hospital of Chicago Last updat","cbCaidgDJkkhUvbX","https://ap.wps.com/l/cbCaidgDJkkhUvbX","pdf",321126,"English","# Inclusion Criteria\n## Exclusion Criteria\n## Respiratory Distress Classification\n## Additional Considerations\n## Treatment Pathway and Disposition","[{\"question\":\"Which infants are included in this bronchiolitis algorithm?\",\"answer\":\"Infants aged 1–24 months with a clinical impression of bronchiolitis are included.\"},{\"question\":\"What conditions exclude a patient from this guideline?\",\"answer\":\"Exclusions include prematurity (GA \\u003c34 weeks and age \\u003c6 months), chronic lung disease on baseline medications or oxygen, unrepaired or hemodynamically significant congenital heart disease, anatomic airway defects, neuromuscular disease, and immunodeficiency.\"},{\"question\":\"What supportive care and escalation steps are recommended for moderate or severe distress?\",\"answer\":\"For moderate distress: nasal suction, spot-check pulse oximetry on room air with vitals, supplemental oxygen if persistently \\u003c90%, consider IV fluids or NG feeds if oral intake is inadequate, and normal feeds as tolerated. For severe distress: nasal suction, supplemental oxygen if persistently \\u003c90%, continuous monitors, IV fluids, and NPO pending respiratory support. If distress remains severe, escalate respiratory support (consider HFNC, CPAP, BiPAP) and urgently escalate for apnea, bradypnea, decreased responsiveness, diminished/absent breath sounds, poor perfusion, or hypoxemia despite supplemental oxygen.\"}]","Emergency Department Bronchiolitis Algorithm | PDF"]