0 points | 1 point | 2 points | 3 points | |
RR | ||||
< 2 mo | < 60 | 61-69 | > 70 | |
2-12 mo | < 50 | 51-59 | > 60 | |
12-24 mo | < 40 | 41-44 | > 45 | |
Retractions | None | Subcostal or intercostal | 2 of the following: subcostal, intercostal, substernal OR nasal flaring (infant) | 3 of the following: subcostal, intercostal, substernal, suprasternal, supraclavicular OR nasal flaring/head bobbing (infant) |
Dyspnea | Normal feeding, vocalizations and activity | 1 of the following: difficulty feeding, decreased vocalization, agitation | 2 of the following: difficulty feeding, decreased vocalization, agitation | Stops feeding, no vocalization, drowsy and confused |
Auscultation | Normal breathing, no wheezing | End-expiratory wheezes only | Expiratory wheeze only | Inspiratory and expiratory wheeze AND/OR diminished breath sounds |
Respiratory Score?
RS 5-8:
RS 1-4:
NOT ROUTINELY RECOMMENDED:
Criteria for initiation of HHFNC (heated high-flow nasal cannula):
See HHFNC Initiation Pathway.
References:
1) John Muir Medical Center Bronchiolitis Clinical Practice Guideline. Internal document.
2) Seattle Children’s Bronchiolitis Pathway v8.0: http://www.seattlechildrens.org/pdf/bronchiolitis-pathway.pdf.
3) Clinical Practice Guidelein: The Diagnosis, Management, and Prevention of Bronchiolitis. American Academy of Pediatrics, 2014. http://pediatrics.aappublications.org/content/pediatrics/early/2014/10/21/peds.2014-2742.full.pdf.
'At risk for asthma' if:
Discharge criteria:
Admit to ICU:
In Emergency Department
Admit to Inpatient floor:
RS 9-12: