Clinical diagnosis
Can consider a blood gas if there are fears that the patient is getting tired (sleepy baby vs elevated CO2?)
A CO2 >45 is abnormal in a patient hyperventilating and warrants close monitoring
A CO2 >45 is abnormal in a patient hyperventilating and warrants close monitoring
1st wheezing episode
Asymmetric lung auscultation findings, after treatment with albuterol
Poor response to medications/treatment, if history and exam are not consistent with bronchiolitis
Worsening symptoms
Fever not explained by apparent viral illness
Diagnosis and treatment can be guided by clinical scores
Modified Pulmonary Index Score (MPIS - Utilized at CCMC)
Pediatric<unk>  Score (PAS)
Pulmonary Score (PS)
Pediatric Respiratory Assessment Measure (PRAM)
Modified Pulmonary Index Score (MPIS - Utilized at CCMC)
Pediatric<unk>  Score (PAS)
Pulmonary Score (PS)
Pediatric Respiratory Assessment Measure (PRAM)
MPIS <7 - Mild<unk> 
MPIS 7-10 - Moderate<unk> 
MPIS ≥10 - Severe<unk>
Acute asthma exacerbation 
Upper Airway diseases
COPD exacerbation
Allergic rhinitis and sinusitis
Acute chest syndrome
Large Airway Obstruction
Acute dyspnea
Foreign body aspiration