This updated guidance is designed to support emergency departments and non-pediatric clinicians caring for children with respiratory illness during periods of pediatric surge, limited specialty access, or while awaiting transfer to higher levels of care. The document serves as a concise, evidence-based reference to assist with rapid clinical decision-making in time-sensitive settings.

Version 2 includes updated pediatric respiratory assessment and management algorithms, clinical guidance on oxygenation and ventilatory support (including high-flow nasal cannula use), medication considerations, and practical appendices such as severity scoring tools and pocket medication references. Content reflects current evidence and expert consensus from pediatric emergency medicine, critical care, pharmacy, and emergency management leaders across multiple states.