What are the discharge criteria for a pediatric patient with minor viral coryza (MvC) and no injury?

Discharge Criteria for Pediatric Minor Viral Coryza (MVC) with No Injury

Pediatric patients with minor viral coryza and no injury can be safely discharged when they demonstrate overall clinical improvement including improved activity level, appetite, and decreased fever for at least 12-24 hours, with oxygen saturation consistently >90% on room air. 1, 2

Key Discharge Criteria

Required Clinical Improvements

• Documented overall clinical improvement for at least 12-24 hours 1
  • Improved level of activity
  • Improved appetite
  • Decreased or resolved fever

Respiratory Status

• Consistent pulse oximetry measurements >90% in room air for at least 12-24 hours 1, 2
• No substantially increased work of breathing 1
• No sustained tachypnea or tachycardia 1
• Resolution of significant respiratory symptoms (cough, coryza) or clear improvement 3

Neurological Status

• Stable and/or baseline mental status 1, 2
• No neurological deficits or changes in mental status 1

Medication Considerations

• For patients requiring outpatient oral medications:
  • Verification that parents can administer medications properly 1
  • Confirmation that children can adequately comply with taking medications 1
  • Documentation that the patient can tolerate their home medication regimen 1, 2

Social and Follow-up Considerations

• Identification and addressing of any barriers to care before discharge, including: 1, 2
  • Concerns about careful observation at home
  • Inability to comply with therapy
  • Inability to be followed up
• Appropriate follow-up arrangements made 2

Contraindications for Discharge

Do not discharge if the patient has:

• Substantially increased work of breathing 1, 2
• Sustained tachypnea or tachycardia 1
• Abnormal mental status or neurological deficits 1
• Inability to maintain oxygen saturation >90% on room air 1, 2
• Marked elevations in inflammatory markers (if tested) 1
• Inability of caregivers to provide appropriate home care 1

Special Considerations for Minor Viral Coryza

While most guidelines focus on pneumonia or more severe respiratory conditions, for minor viral coryza specifically:

• Most cases are self-limiting and can be managed at home with supportive care 3
• Common symptoms include coryza (70.7%), cough (69.3%), and sneezing (26%) 3
• Ensure adequate hydration and ability to feed before discharge
• Provide caregivers with clear instructions on when to seek medical attention if symptoms worsen

Caregiver Education Before Discharge

• Explain expected course of illness
• Provide instructions for supportive care (hydration, fever control)
• Review warning signs that should prompt return to medical care
• Ensure caregivers understand and can implement home care instructions

By following these discharge criteria, healthcare providers can ensure safe transitions of care for pediatric patients with minor viral coryza while minimizing unnecessary hospital stays.