Table 4 Factors affecting the decision to admit children to the hospital
Possible discharge | Brief observation | Hospitalization | |
|---|---|---|---|
Respiratory effort | None or mild chest wall retraction | Tracheal tug, nasal flare, Moderate chest wall retraction | Moderate-to-severe respiratory distress, apnea |
Oxygen saturation | No supplemental oxygen requirement, saturations > 95% | Saturations 90–95% | Saturations persistently < 90–92%, O2 requirement |
Feeding | Normal to slightly decreased | 50–75% of normal feeds | <50% of feeds, unable to feed, dehydration |
Gestational age | Gestational age >37 weeks, birth age >12 weeks | Gestational age <37 weeks, birth age <6–12 weeks | |
Responsivity and alertness | Reactive, vigilant | Less or not responsive | |
Social factors | Good parent compliance, hospital easily accessible | Non-collaborative parents, Distant from hospital | |
Preexisting risk factors | No risk factors | BPD, cystic fibrosis, cyanogenic congenital heart disease, immunodeficiency, neuromuscular disease | BPD, cystic fibrosis, cyanogenic congenital heart disease, immunodeficiency, neuromuscular disease |