Asthma Inpatient Pediatric Pathway Algorithm

Initial Assessments by MO, RT, RN Review ED Treatments PAS Score

Inclusion Criteria: age > 2 years, known asthma or cough responsive to bronchodilator, no comorbid conditions such as CF, CHF

Eligible for Pathway?

NO Care appropriate to diagnosis and condition

Requirement to advance: No worsening in any aspect of pre-treatment PAS, >1 treatment within each phase of the pathway, improvement of > 2 in PAS on current phase or total score < 7

YES

Initiate PHASE 1 RT assessment Oxygen as required Albuterol/Levalbuterol as indicated

Based on assessment able to advance on Pathway?

NO Notify MO

YES

Discharge to home once PHASE 3 complete and criteria met.

Begin PHASE 2, if continued improvement advance to PHASE 3.

If worsens or not improving, notify MO.

Discharge Criteria: 1. 2. 3. 4. 5. 6. PAS < 7 with bronchodilator therapy spaced to > 4 hours Maintaining oxygen saturations > 92 % in room air. Discharge medications prescribed, obtained by the patient and/or family, and patient/parents able to demonstrate an understanding of their use and administration. Completion of asthma education to include an Asthma Action Plan. Patient/parents demonstrate understanding of guidelines for a return to the Emergency Department. Referral placed in CHCS to Pediatric Asthma clinic. Follow up with primary care manager guaranteed within 24 -72 hours of hospital discharge.