This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Referral criteria from primary care - bronchiolitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • Immediately refer children with bronchiolitis for emergency hospital care (usually by 999 ambulance) if they have any of the following:
    • apnoea (observed or reported)
    • child looks seriously unwell to a healthcare professional
    • severe respiratory distress, for example grunting, marked chest recession, or
    • a respiratory rate of over 70 breaths/minute
    • central cyanosis

  • consideration of referral for a child with bronchiolitis to hospital if they have any of the following:
    • a respiratory rate of over 60 breaths/minute
    • difficulty with breastfeeding or inadequate oral fluid intake (50-75% of usual volume, taking account of risk factors and using clinical judgement)
    • clinical dehydration
    • persistent oxygen saturation of less than 92% when breathing air


  • when deciding whether to refer a child with bronchiolitis to secondary care, take account of the following risk factors for more severe bronchiolitis:
    • chronic lung disease (including bronchopulmonary dysplasia)
    • haemodynamically significant congenital heart disease
    • age in young infants (under 3 months)
    • premature birth, particularly under 32 weeks
    • neuromuscular disorders
    • immunodeficiency

  • When deciding whether to refer a child to secondary care, take into account factors that might affect a carer's ability to look after a child with bronchiolitis, for example:
    • social circumstances
    • the skill and confidence of the carer in looking after a child with bronchiolitis at home
    • confidence in being able to spot red flag symptoms
    • distance to healthcare in case of deterioration

Provide key safety information for parents to take away for reference for children who will be looked after at home. This should cover:

  • how to recognise developing 'red flag' symptoms:
    • worsening work of breathing (for example grunting, nasal flaring, marked chest recession)
    • fluid intake is 50-75% of normal or
    • no wet nappy for 12 hours


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.