Spectrum: Local Antimicrobial Stewardship, for UCLA Health

Bronchiolitis

Criteria

Inclusion Criteria

  • Age: 1mo – 2yo with rhinitis

  • Cough

  • Signs of lower respiratory tract infection

  • Increased WOB (e.g. grunting, flaring, retracting, wheezing, tachypnea)

Higher incidence December through May (RSV season)

Exclusion Criteria

  • Known asthma or reactive airway disease

  • Recurrent cough/wheeze

  • Prior steroid use

  • Sepsis Criteria (See Sepsis Clinical Pathway)

Supportive Care

Bulb suction PRN

Maintain hydration

Antipyretics PRN

Triage

Triage Algorithm

Treatment

Severe Bronchiolitis

RR
1 - 3 mos: > 80 or apnea
3 mos - 1 yo: > 70
1 yo - 2 yo: > 60

WOB: Severe retractions, nasal flaring, grunting, head bobbing

Mental Status: Lethargic or inconsolable

Moderate Bronchiolitis

RR
1 - 3 mos: 61 – 80
3 mos - 1 yo: 51 – 70
1 yo - 2 yo: 41 – 60

WOB: Moderate retractions

Mental Status: Fussy or anxious

Mild Bronchiolitis

RR
1 - 3 mos: 30 – 60
3 mos - 1 yo: 25 – 50
1 yo - 2 yo: 20 – 40

WOB: None, mild retractions

Mental Status: Baseline

More Information

References

Revisions and Approvals

Revision date: November 2017
Approval date: November 2017
Next revision date: October 2019