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Outpatient Criteria for Discharge

  • Resolution of respiratory distress and infrequent respiratory care needs:

    • Respiratory rate for the infant is near 60 breaths per minute or less.

    • There is minimal to no increased work of breathing

    • Stable without the need for nasopharyngeal suctioning for an adequate length of time.

  • Nutrition:

    • The patient is able to maintain adequate hydration with oral feedings.

  • Medication/Durable medical equipment:

    • If the patient is receiving intravenous medications, convert to oral medications if the child will be going home on the medications.

    • If the patient responded to bronchodilators consider similar medication for home use along with appropriate durable medical equipment (spacer with mask).

    • Bulb syringe.

  • Social/Education:

    • Parental comfort with discharge plans.

    • Family or caregiver has the resources to care for the child.

    • Parent education on:

      • How to use a bulb syringe with or without nasal saline.

      • The expected course of illness - the course may be variable many children will have up to six weeks of cough and/or nasal congestion.

      • The signs and symptoms of respiratory distress - increased respiratory rate or labored breathing (including abdominal breathing, retractions, tracheal tug or nasal flaring).

      • Home intervention when distress occurs - suctioning, fever control.

      • The signs and symptoms of dehydration - dry mouth, no tears, cool extremities, infrequent or small voids.

    • Explain Bronchiolitis Care Card (EnglishEspañol) to parents.

    • Contact the primary care physician about the discharge plans and arrange for follow up evaluation.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.