RSV Discharge Instructions for a 3-Year-Old
Your child can be safely discharged home with supportive care measures, as RSV in a 3-year-old is typically a self-limited illness requiring only symptom management and close monitoring for warning signs of deterioration. 1
Discharge Readiness Criteria
Your child should meet all of the following before going home:
- Oxygen saturation consistently >90% in room air for at least 12-24 hours 2
- Overall clinical improvement including better activity level, improved appetite, and decreased or absent fever for at least 12-24 hours 2
- Normal or baseline mental status 2
- No substantially increased work of breathing, sustained tachypnea, or tachycardia 2
- Able to maintain adequate oral fluid and food intake 1
Home Care Instructions
Hydration and Nutrition
- Ensure your child drinks adequate fluids throughout the day 1
- Offer small, frequent feedings if appetite is reduced 1
- Watch for signs of dehydration: decreased urine output, dry mouth, no tears when crying, sunken eyes 1
Symptom Management
- Use acetaminophen or ibuprofen for fever or discomfort as needed 1
- Nasal saline drops or spray can help relieve nasal congestion 1
- Keep your child's head slightly elevated during sleep to ease breathing 1
Infection Control
- Hand hygiene is the single most important measure to prevent transmission to others 1
- Use alcohol-based hand sanitizer or wash hands thoroughly before and after caring for your child 1
- Keep your child away from other children, especially infants, until symptoms resolve 1
- Avoid exposing your child to tobacco smoke, which worsens respiratory symptoms 1
Warning Signs: Return to Emergency Department Immediately If:
- Oxygen saturation falls below 90% (if you have a home pulse oximeter) 2
- Increased work of breathing: visible chest retractions, flaring nostrils, grunting sounds 2
- Rapid breathing that doesn't improve with rest 2
- Bluish color around lips or fingernails 1
- Difficulty breathing or appears to be struggling to breathe 2
- Lethargy, difficulty waking, or altered mental status 2
- Refusing to drink or signs of dehydration 1
- Apnea (pauses in breathing) 3
- High fever that persists or worsens after 48-72 hours 1
What NOT to Expect or Use
- Do NOT expect antibiotics unless there are specific signs of bacterial co-infection 1
- Do NOT use over-the-counter cough and cold medications 1
- Palivizumab (Synagis) has no therapeutic benefit for treating established RSV infection—it is only for prevention in high-risk infants 1
Expected Recovery Timeline
- Most children improve within 48-72 hours and fully recover within 1-2 weeks 3, 4
- Cough may persist for 2-3 weeks even as other symptoms resolve 3
- Your child is most contagious during the first 3-8 days of illness 5
Follow-Up Care
- Schedule a follow-up visit with your pediatrician within 2-3 days of discharge 1
- Return sooner if your child is not improving after 48 hours at home 1
- Contact your pediatrician if new symptoms develop or existing symptoms worsen 1