Which is an indication for hospitalization in a child with acute bronchiolitis?

• A. Pulse oximetry of 94% on room air.
• B. Children between 4-6 months of age.
• C. Moderate tachypnea with feeding difficulties.
• D. Hyperinflation and interstitial infiltrates on chest x-ray.

Answer: (C)

Indications for hospitalization in acute bronchiolitis arise when the child shows signs of significant respiratory distress and/or dehydration. The best indicator here is moderate tachypnea with feeding difficulties because it reflects that the child is tiring from the work of breathing and is at risk for dehydration due to poor oral intake. This combination means the child needs closer monitoring, IV fluids if needed, and potential escalation of care in a hospital setting.

An oxygen saturation of 94% on room air suggests adequate oxygenation and by itself would not mandate admission. Age range can influence risk but is not an automatic admission criterion. Chest x-ray findings like hyperinflation or interstitial infiltrates are not routinely used to decide hospitalization and can be seen in bronchiolitis without requiring admission.