Approach to the Critical Patient

Immediate priorities

Airway and breathing threats

Stabilization priorities

Monitoring and targets

Monitoring parameters

Escalation triggers

Immediate consults

Consultation triggers

History

Presentation pattern

Cardinal symptom sequence

Timeline and trajectory

Alarm features

High-risk symptoms

Absence of URI prodrome

Risk factors

Host risk factors for severe disease

Environmental and social risk factors

Prophylaxis and immunization status

Epidemiologic context

Seasonal and demographic factors

Physical Exam

Vital signs and general

Stability snapshot

Hydration and general status

Respiratory exam

Work of breathing

Auscultation findings

PITFALLS

Exam variability

Missed severity markers

Differential Diagnosis

Life-threatening diagnoses

Immediate threats

Infectious mimics

Respiratory infections

Reactive airway disease

Structural and anatomical diagnoses

Airway anomalies

Cardiac structural disease

Laboratory Tests

Routine labs

Labs NOT routinely recommended (AAP guidelines)

Selective laboratory testing

When to consider labs

Cardiac laboratory evaluation

Viral testing panel indications

Diagnostic Tests

Scoring Systems

Severity scoring tools

MRI

MRI role in bronchiolitis

CT

CT chest role in bronchiolitis

Ultrasound

Lung ultrasound role

ECG considerations

Disposition

Admission criteria

Indications for inpatient admission

ICU admission triggers

Discharge criteria and observation

Criteria for safe discharge

Observation period guidance

Follow-up planning

Post-discharge follow-up

Treatment

Supportive care

Nasal suctioning

Oxygen therapy

Hydration management

Oral or enteral feeds

Intravenous fluid therapy

Treatments NOT recommended

Evidence-based non-recommendations (AAP/NICE guidelines)

Antipyretics and comfort

Fever management

Prevention (immunoprophylaxis)

Nirsevimab (Beyfortus)

Clesrovimab (Enflonsia)

Maternal RSV vaccination (Abrysvo)

Palivizumab (Synagis)

Special Populations

Pregnancy

Maternal RSV infection considerations

Drug safety in pregnancy

Geriatric

RSV in older adults

Comorbidity implications

Pediatrics

Age-specific severity thresholds

High-risk pediatric conditions

Post-bronchiolitis long-term risk

Background

Epidemiology

Disease burden

Global and demographic burden

Pathophysiology

RSV biology

Disease mechanism in bronchiolitis

Cardiac manifestations

Therapeutic Considerations

Evidence base for supportive care

Emerging and investigational therapies

Prevention as cornerstone of disease management

Patient Discharge Instructions

copy discharge instructions

What is bronchiolitis

Home care instructions

Warning signs: return to ER immediately if

Follow-up

References

Guidelines and key sources

AAP and major society guidelines

Landmark trials and systematic reviews

Recent evidence and real-world data

Coding references

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.