respiratory Distress

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CX infography

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respiratory Distress

Stridor

atypical

CTA

Bronchoscopy

chest CT

typical

Racemic epi and Dexa one dose; O2; suctioning

stress at rest

ICU

Intubation?

Dexa

Heliax

Improved

Humidified air

wheezing component

Wheezing

Albuterol/Atrovent doubles once or 3

No Improvement, but the child looks comfortabe

Bronchiolitis

supportive tx: O2 ; suctioning

occasinally racemic epi

Improvement

Astham (RAD)

For URI symptoms

Respiratory screen

If +

CXR

Parial Improvement

Steroids

IV Solumedrol

Orapred

inhalers

Albuterol/Atrovent doubles X 3

Albuterol continuous 10, 15 or 20

more than 1 hr

to ICU

Continue Albuterol continues

less than 1 hr

relapse less than one hour off

well for more than 1 hr off

to Floor

Albuterol/Atrovent single or double starting at q2/q1spaced to q4/q2 then q 6/q4

No improvment

Repeat CXR

Atelectasis

Consider Abx for atypical pneumonia

Chest PT, Spirometer

Improvment

Discharge

Consider referring for allergy

Consider Singulair

Consider adding steroids/long acting beta

Advir

Strength 500

Strength 250

strength 100

consider adding inhaer steroids

Pulmicort

Flovent

Consider adjusting the albuterol

Nebulizer

MDI spacer

Orapred 5 d

Complete improvement