We ended up in the hospital last weekend. We went in to the ER at 3am, her RR was in the upper 50's. They deep suctioned her and we waited around for a few hours... she was on the edge so they let me decide if I could take her home... we tried taking her home (her sats were hovering at 92, they admit when they drop below 92). 3 hours later, we went into our hospital's suction clinic and she'd tipped over the edge. The RT sent us back into the ER, and she was admitted on oxygen. She stayed on O2 for that night, she was off O2 and maintained her sats the next night and we were home the following morning.
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For future reference, those are pretty mild retractions with a slow respiratory rate. Unless he had faster breathing and retractions earlier and is now slowing down, I'd be tempted to wait, especially since the O2 sats are good. Respiratory rate appears to be well under 50/min which is the cutoff for our Children's hospital.
In the situation shown above, before I'd go into the hospital, I'd go into a bathroom and run a warm shower for about 30 minutes (or if I hear a croupy cough, I'd go outside or in front of a freezer to reduce swelling, then into a warm steamy bathroom). First thing after starting the shower, I'd suction the nose with saline(I use a nosefrida and a graco battery powered nasal aspirator). After the 30 minutes, I'd suction again if baby wasn't easily breathing through nose.
I'd recheck respiratory rate and check for retractions and as long as they were mild to non-existent, I'd wait until morning to see either my pediatrician or urgent care. We have a local nurse line to call and check symptoms with, so if I was feeling at all antsy, I'd call them and run through what I've done and what her vitals were at the time. I usually count a full 60 seconds of breathing for respiratory, just to be sure... but if I'm over 25 at 30 seconds, I'm going to take the kiddo in...
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