Red flags & when to go in person for Bronchiolitis (Infant) - Triage

Audience: adult

Bronchiolitis is a common lung infection in infants that causes swelling and mucus buildup in the small airways of the lungs. It often starts with cold-like symptoms such as a runny nose and mild cough but can sometimes lead to difficulty breathing. Most infants recover at home with rest, fluids, and monitoring. However, some signs mean the infant needs urgent medical care. These include trouble breathing, poor feeding, or unusual sleepiness. Telemedicine can help caregivers understand symptoms and decide when to seek in-person care. It can provide advice on managing mild symptoms and when to watch closely. But telemedicine cannot replace a physical exam or emergency treatment if the infant is very sick. Knowing the red flags and when to go in person can help keep your infant safe and get the right care quickly.

Red flags — go in person / ER

• Infant breathing faster than 60 breaths per minute or showing signs of labored breathing such as chest retractions or nasal flaring — seek emergency care immediately.
• Blue or gray coloring around the lips, face, or tongue indicating low oxygen — call emergency services right away.
• Infant unable to feed or drink fluids, leading to dehydration — get urgent medical evaluation.

What telemedicine can do

• Providing education about bronchiolitis and its symptoms.
• Assessing general condition based on caregiver’s description and visual cues.
• Guiding caregivers on home care measures and monitoring.
• Advising when to seek in-person or emergency care.

What telemedicine cannot do

• Performing physical examination such as lung auscultation.
• Administering emergency treatments like oxygen therapy.
• Diagnosing complications or severe illness requiring hospital care.
• Providing treatments that require medical equipment or medications not available at home.

What is Bronchiolitis in Infants?

Bronchiolitis is an infection that affects the smallest airways in a baby's lungs. It usually happens in babies under 2 years old, especially during cold seasons. The infection causes swelling and mucus, making it harder for the baby to breathe. Common symptoms include a runny nose, cough, wheezing, and sometimes fever. Most cases improve with simple care at home.

Common Symptoms to Watch For

Early signs of bronchiolitis often look like a mild cold:

These symptoms usually get better in 1 to 2 weeks. Keep the baby comfortable and hydrated, and monitor their breathing closely.

Red Flags: When to Seek In-Person Care Immediately

Some signs mean the baby needs urgent medical attention. Seek in-person care if your infant has:

These signs may mean the baby needs emergency care or hospital treatment.

How Telemedicine Can Help

Telemedicine allows you to talk with a healthcare provider without leaving home. For bronchiolitis, telemedicine can:

It is a useful tool for education and triage but cannot replace a physical exam or emergency treatment.

Limitations of Telemedicine for Bronchiolitis

Telemedicine cannot:

If your baby shows any red flags, go to a healthcare facility immediately, even if you have a telemedicine appointment scheduled.

Preparing for a Telemedicine Visit

Before your telemedicine appointment:

This information helps the provider give the best advice.

How to prepare for your tele-visit

• Note the infant's current symptoms and how they have changed over time.
• Measure and record the infant's breathing rate if possible.
• Have information about feeding patterns and fluid intake ready.
• Prepare a quiet and well-lit area for the telemedicine visit.
• Have a list of any medications or treatments the infant is currently receiving.
• Be ready to describe any red flag symptoms you have observed.

After your tele-visit

• Follow the healthcare provider’s advice on monitoring symptoms and home care.
• Keep track of any new or worsening symptoms, especially red flags.
• Ensure the infant stays hydrated and comfortable.
• Schedule follow-up care if recommended.
• Seek in-person care immediately if red flag symptoms develop or worsen.
• Use emergency services if the infant shows signs of severe distress.

FAQs

What causes bronchiolitis in infants?

Bronchiolitis is usually caused by a viral infection, most commonly the respiratory syncytial virus (RSV). It leads to swelling and mucus buildup in the small airways of the lungs.

Can bronchiolitis be treated at home?

Many cases of bronchiolitis are mild and can be managed at home with rest, fluids, and careful monitoring. However, some infants may need medical care if symptoms worsen.

When should I take my infant to the emergency room?

Go to the emergency room if your infant has trouble breathing, blue or gray lips, is very sleepy or difficult to wake, has a high fever lasting several days, or cannot feed properly.

Can telemedicine replace in-person visits for bronchiolitis?

Telemedicine can help with education and deciding when to seek care, but it cannot replace physical exams or emergency treatments needed for severe bronchiolitis.

How can I help my infant feel better at home?

Keep your infant comfortable, ensure they drink enough fluids, use a humidifier if advised, and monitor their breathing and behavior closely.

Sources

1. Bronchiolitis — MedlinePlus, U.S. National Library of Medicine.
2. Bronchiolitis in Children: Clinical Overview — Centers for Disease Control and Prevention (CDC).
3. Bronchiolitis — Mayo Clinic.
4. Bronchiolitis — Merck Manuals: Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care. If your infant shows any red flag symptoms or you are concerned about their health, seek immediate medical attention.