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Inpatient Laboratory Tests and Chest x-rays

The Bronchiolitis CPG Team recommends not routinely obtaining laboratory tests such as CBC & Diff w/platelets, Basic Metabolic Panel, Blood Culture, RSV antigen detection, Flu A &B antigen, or chest x-ray for the infant who is presenting for the first time with symptoms of bronchiolitis.  The recommendation concurs with the AAP (2006) and Scottish Intercollegiate Guidelines Network (SIGN, 2009) bronchiolitis guidelines. RSV antigen testing maybe obtained if applied to cohorting infants on inpatient units. Bronchiolitis is diagnosed based on history and physical examination (AAP, 2006). We placed high value on avoiding unnecessary medical testing and reduction of discomfort to the patient.

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.