›Risk stratification tool
›D dimer when appropriate
›CT pulmonary angiography when indicated
›Blood gas strategy
›Venous blood gas for ventilatory failure concern
›Arterial blood gas when severe hypoxia with unclear cause
Therapeutics by phenotype
›Bronchospasm treatment
›Salbutamol inhaled 4 to 8 puffs via spacer
›Repeat every 20 minutes for 1 hour if severe
›Ipratropium inhaled 4 to 8 puffs via spacer
›Prednisone PO 50 mg once daily
›Duration 5 days local protocol dependent
›Pneumonia treatment
›Antibiotic selection local protocol dependent
›Avoid antibiotics for uncomplicated acute bronchitis
›Sepsis bundle when shock physiology
›Croup treatment
›Dexamethasone PO or IM 0.6 mg per kg
›Maximum 10 mg
›Nebulized epinephrine for stridor at rest local protocol dependent
›GERD and upper airway cough syndrome pathway
›Trial therapy outpatient when stable
›Avoid empiric antibiotics
›Reassessment timing
›After each bronchodilator cycle
›Every 30 to 60 minutes in moderate respiratory distress
›Vital sign trend documentation
›Oxygen requirement trend
›Work of breathing trend
›Consult triggers
›ENT for suspected epiglottitis or deep neck infection
›Pulmonology for persistent hemoptysis or suspected ILD
›ICU for escalating oxygen requirement or hypercapnia
›Pediatrics for infant respiratory distress