Title: 'Tis the season ... for bronchiolitis (submitted by Heather Mezzadra, MD)<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><div style="color: rgb(187, 165, 4); font-size: 12px; font-weight: bold; font-family: verdana, arial, helvetica, sans-serif; ">
<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;"><span style="">The AAP, in conjunction with the American Academy of Family Physicians (AAFP), the American College of Chest Physicians (ACCP), and the American Thoracic Society (ATS), published the following recommendations for admission for patients with bronchiolitis:</span></span></div>
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<span style="color: rgb(102, 102, 102); font-size: 10px; ">- Persistent resting oxygen saturation below 92% in room air before beta-agonist trial (be sure to watch the patient sleeping, as the O2 saturation can drop even further)</span></div>
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<span style="color: rgb(102, 102, 102); font-size: 10px; ">- Markedly elevated respiratory rate (> 70-80 breaths per min)</span></div>
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<span style="color: rgb(102, 102, 102); font-size: 10px; ">- Dyspnea and intercostal retractions, indicating respiratory distress</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Desaturation on 40% oxygen (3-4 L/min oxygen), cyanosis</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Chronic lung disease, especially if the patient is on supplemental oxygen</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Congenital heart disease, especially if associated with cyanosis or pulmonary hypertension</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Prematurity</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Age younger than 3 months, when severe disease is most common</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Inability to maintain oral hydration in patients younger than 6 months</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Difficulty feeding as a consequence of respiratory distress</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">- Parent unable to care for child at home</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">Reference:</span></div>
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<span style="color:#666666;font-size:10px;font-family:verdana,arial,helvetica,sans-serif;">Diagnosis and management of bronchiolitis. <em style="color: rgb(102, 102, 102); font-family: verdana, arial, helvetica, sans-serif; font-size: 10px; ">Pediatrics</em>. Oct 2006;118(4):1774-93.</span></div>
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