Bronchiolitis Clinical Pathway — Emergency Department

Triage

Respiratory Distress

1 Critical	2 Acute	3 Urgent	4 Urgent	5 Non-Urgent
Severe wheezing/stridor with: Severe tachypnea Bradypnea/apnea Severe retractions Grunting respirations Decreased muscle tone Lethargy Absent breath sounds Agonal respirations Pulse oximetry < 90%	Wheezing/stridor with moderate: Increased WOB Nasal flaring Tachypnea Retractions Prolonged expiration Intermittent grunt Decreased aeration with moderate tachypnea and WOB Pulse oximetry < 92% Stridor at rest Asthmatic with Hx of intubation	Wheezing/Stridor with mild: Increased WOB Tachypnea Retractions	Wheezing with minimal: WOB Tachypnea Retractions Pulse oximetry > 95% Hx of neb within the hour

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.