Resp Score 1
ED PHASE 1B: Reassessment (2nd Hour)
O2 sat <92% on 2LNC or 40%FM?
Consider BiPAP, magnesium sulfate, chest X-ray, continuous albuterol, and/or PICU consult
Phase #2
Phase #4
Phase #3
Resp Score 1-4
Resp Score 1-4
Resp Score 9-12
Resp Score 9-12
Resp Score 9-12
Resp Score 9-12
Resp Score 1-4
Signs of Clinical Decline
Notify MD and consider PMET activation
Escalation - Notify MD
Consider PMET activation
Resp Score 2-5
Phase #1
INPATIENT: PHASE 2
Medication Dosing
ALL MEDICATION REQUIRE AN MD ORDER
**ED & Inpatient
Albuterol dosing:
Continuous albuterol via nebulizer:
Ipratropium bromide: 500 mcg nebulized
Prednisone or Prednisolone (oral):
Dexamethasone: 0.3 mg/kg (max 10 mg)
Methylprednisolone:
Discharge/Home
Albuterol dosing:
Adjunct Therapies
RN/RT to Notify MD
Resp Score 5-8
Resp Score 6-12
Resp Score 5-8
INPATIENT: PHASE 4
ED PHASE 1A: Initial Assessment (1st Hour)
Resp Score 1-4
Resp Score 5-8
Discharge Plan
If you have questions about any of the clinical pathways or about the process of creating a clinical pathway please contact the Clinical Pathway Oversight Committee at CPOC@montefiore.org.
Disclaimer: Clinical pathways are intended as a resource to guide diagnosis, treatment and management in order to improve quality of care and promote better patient outcomes. They are based on available medical evidence at the time of development; the date on the pathway indicates the most recent update. Pathways are not intended to provide medical advice or consultation regarding the care of any individual patient, and should not replace or supersede a practitioner’s professional opinion or clinical judgment. Because medical knowledge is constantly evolving, and accepting the possibility of error, The Children’s Hospital at Montefiore does not warrant or represent that pathways are complete or accurate. Neither the Hospital nor the individuals involved in the development or publication of the pathways is responsible for results or outcomes related to their use.
INPATIENT: PHASE 3
Resp Score 5-8