Pathway Background and Objectives
Bronchiolitis, a viral infection of the lower respiratory tract that primarily affects infants ages 0-24 months, is the most frequent cause of hospital admission for children under 1 year of age, accounting for upwards of 18% of all hospitalizations in the United States. At ~150,000 admissions per year, it is the most common cause of hospital admission during the first year of life, with an approximated annual cost of ~$1.73 billion dollars nationally. In 2014, the AAP published updated guidelines on the diagnostic work up, treatment, and prevention of bronchiolitis. Previously there had been variation in practice amongst providers, and little evidence to support certain commonly used modalities of diagnosis and treatment.
The objectives of this pathway are to:
- Standardize delivery of evidence based care to infants with bronchiolitis
- Avoid routine use of therapies and testing that have been shown to have little clinical benefit (i.e. routine viral testing, chest x-rays, antibiotic use, steroids, bronchodilators)
- Maximize the usage of enteral hydration when appropriate (by mouth and/or nasogastric tubes)
- Decrease unnecessary continuous pulse oximetry use