RDP: Bronchiolitis

Respiratory Driven Protocols are something that should be really pushed. I honestly don't see ventilator settings being a RDP type thing, since Respiratory Practitioners are quite capable of completely managing a patient on a ventilator. Doctors being able to modify the settings, sure, but only by order. It should be a very unified standard of care that an RP is completely responsible for the safety and outcomes related to ventilator care. However, there are some things, like Asthma or Bronchiolitis that I will not argue should be under a protocol guidance.

Bronchiolitis

"Respiratory eval & treat"

Evaluate for a complex Respiratory Distress Score tailored to Bronchiolitis.

Automatic: Respiratory eval for Bronchiolitis RDS Q4H

Automatic: Suction at bedside PRN

Automatic: 3% NaCl Q4H with suctioning 20 minutes after NaCl delivery

Automatic: Corticosteroid of preference Q6H

During assessments:

If wheeze of any kind: Nebulized epinephrine (racemic is okay) Q4H PRN

This bronchiolitis protocol requires a ton of clinical judgment on the behalf of the respiratory practitioner. That is fine, respiratory practitioners are fully capable of managing this kind of thing. To help maintain competence: in-services about bronchiolitis are definitely recommended too.

What do you think? Do you have a Bronchiolitis RDP?