Laboratory Tests and Chest X-rays

The Bronchiolitis CPG Committee recommends not routinely obtaining laboratory tests such as CBC & differential, basic metabolic panel, blood culture, RSV PCR, Flu A&B PCR, or chest x-ray for the infant who is presenting for the first time with symptoms of bronchiolitis.  The recommendation concurs with the American Academy of Pediatrics (AAP) bronchiolitis clinical practical guideline (Ralston et al., 2014). RSV PCR testing may be obtained if attempting to cohort infants on inpatient units. Bronchiolitis is diagnosed based on history and physical examination (Ralston et al., 2014). High value is placed on avoiding unnecessary medical testing and reduction of discomfort to the patient.

Reference:

Ralston, S. L., Lieberthal, A. S., Meissner, H. C., Alverson, B. K., Baley, J. E., Gadomski, A. M., ... & Hernandez-Cancio, S. (2014). Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics, 134(5), e1474-e1502.