Bronchiolitis Flashcards
What is Bronchiolitis?
Inflammation and infection in the bronchioles, the small airways of the lungs.
What is the most common cause of bronchiolitis?
Respiratory syncytial virus (RSV)
When are the symptoms of bronchiolitis typically worse?
Day 3 or 4
How long do symptoms tend to last in bronchiolitis?
7-10 days
How long does it take patients to fully recover from bronchiolitis?
2-3 weeks
What is bronchiolitis the main cause of?
Serious lower respiratory tract infection in children under 1 year.
When is bronchiolitis more common?
In winter
Who does bronchiolitis typically affect?
Children who are 3-6 months.
What provides protection against RSV in new borns?
Maternal IgG
When would bronchiolitis be more serious?
If the child had:
• bronchopulmonary dysplasia (e.g. Premature)
• Congenital heart disease
• Cystic fibrosis
What is the main presentation of bronchiolitis?
Coryzal symptoms
What other symptoms can Bronchiolitis present with?
- dry cough
- increasing breathlessness
- wheezing, fine inspiratory crackles (not always present)
- feeding difficulties associated with increasing dyspnoea
What is not always present with bronchiolitis?
Wheezing, fine inspiratory crackles (not always present)
What is the main thing to look out for with Bronchiolitis?
Respiratory distress
What are signs of respiratory distress?
- Raised respiratory rate
- Use of accessory muscles of breathing,
- Intercostal and subcostal recessions
- Nasal flaring
- Head bobbing
- Tracheal tugging
- Cyanosis (due to low oxygen saturation)
- Abnormal airway noises
Where are most children with Bronchiolitis managed?
At home
What would be reasons to admit a child?
- apnoea (observed or reported)
- child looks seriously unwell to a healthcare professional
- severe respiratory distress,
- Respiratory rate of over 70 breaths/minute
- central cyanosis
- Clinical dehydration
- Oxygen saturation less than 92% when breathing air.
- Aged under 3 months or any pre-existing condition such as prematurity, Downs syndrome or cystic fibrosis
A respiratory rate of what would indicate that a child should be admitted?
More than 70
What oxygen saturation would suggest that the child should be admitted?
Less than 92% on air
What investigation can be done for Bronchiolitis?
Immunofluorescence of nasopharyngeal secretions may show RSV
What is the management of bronchiolitis?
Supportive management
What is the supportive management for bronchiolitis?
humidified oxygen given via a head box if the oxygen saturations are persistently < 92%
Ensuring adequate intake- orally, via NG tube or IV fluids
Saline nasal drops and nasal suctioning- clear nasal secretions
What is Palivizumab?
A monoclonal antibody that targets the respiratory syncytial virus.
A monthly injection is given as prevention against bronchiolitis caused by RSV
Given to high risk babies
