Viral URI

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Counseling

Colds usually last about 10 days, and cough can last longer.

Supportive careChoose anyParagraph

Counseling

Return precautions given including trouble breathing, prolonged fever, ear pain, not drinking well, symptoms that get worse after starting to improve, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

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Viral URI
• Well appearing and well hydrated
• Lungs clear without signs of pneumonia
• No acute otitis media
• Antibiotics not indicated for a viral illness
• Follow up as needed for worsening or concerns

Colds usually last about 10 days, and cough can last longer. Recommended supportive care with OTC medications as needed with an emphasis on hydration, saline nose drops, and honey for cough in children 1 year and older. Return precautions given including trouble breathing, prolonged fever, ear pain, not drinking well, symptoms that get worse after starting to improve, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

No signs of bacterial sinusitis (not > 10 days, not worsening after improvement, not severe)
Antibiotics not indicated for a viral illness
No OTC cough and cold medicine under 4 (6 per CDC)
Saline, suction or nose blowing; suction before feeds
Honey for cough at 1 year and older; none under 1
Humidifier, fluids
Acetaminophen or ibuprofen for fever or discomfort
Course: colds last about 10 days; fever early
Return for trouble breathing, symptoms > 10 days or worse after improving, prolonged fever, ear pain, poor drinking

Used to decide, kept out of the note

Inhaled or oral steroids don't help without asthma

Return precautions in the template

trouble breathingprolonged feverear painnot drinking wellsymptoms that get worse after starting to improve

Sources

CDC. Outpatient Clinical Care for Pediatric Populations (antibiotic prescribing table)
AAP / HealthyChildren.org. Coughs and Colds: Medicines or Home Remedies?
AAP Clinical Practice Guideline for acute bacterial sinusitis (Wald 2013), as summarized in CDC row
Common cold (CDC)
Bacterial sinusitis criteria (CDC sinusitis row, from AAP 2013 CPG)