What is an indicator that a child's respiratory condition might be serious enough to need hospitalization?

The inability to lie flat is a significant indicator that a child may require hospitalization for a respiratory condition. When a child cannot lie flat comfortably, it often suggests severe respiratory distress or increased work of breathing. This condition can arise from issues such as significant airway obstruction, pneumothorax, or congestive heart failure where lying flat exacerbates breathing difficulties.

In contrast, while mild wheezing, an SpO2 of 95% on room air, and short episodes of coughing may indicate a respiratory condition, they do not necessarily suggest a level of severity that requires hospitalization. Mild wheezing can often be managed at home or with outpatient care, and SpO2 levels of 95% are generally acceptable, indicating adequate oxygenation in many children. Short episodes of coughing, likewise, can be common and are not always an indication of a serious condition. Therefore, the inability to lie flat is a critical sign that points toward a potentially serious issue needing inpatient treatment.