Bronchiolitis Flashcards
define bronchiolitis and who gets it
acute LRTI with inflammation of small airways
-affects infants mainly
causes of bronchiolitis 6
using due to respiratory syncytial virus RSV (50-90%)
parainfluenza
influenza A
rhinovirus
adenovirus
human metapneumovirus
presenation of bronchiolitis 5
cough
dyspnoea
hyperinflation
recession
fine creps and wheeze on asculatation
timeline of bronchiolitis illness
incubatino 5 days
coryzal syx 1-3 days
Lower respiratroy syx buid to peak between 3-5
syx last for 7-21 days
management of bronchiolitis 4
O2 if hypoxic
NG feeds or IV fluids if poor feeding
saline nasal drops and nasal suctioning- help clear nsal secretions particulary prior to feeding
ventilation if required
prevalence of bronchiolitis throughout the year
v common in winter october-april
signs of respiratory distress in an infant 8
raised RR
use of accessory muscles for breathing
intercostal and subcostal recession
nasal flaring
head bobbing
tracheal tugging
cyanosis
abnormal airway noises
accessory muslces used for breathing 3
sternocleidomastoid
abdominal muscles
intercostal muscles
immunotherapy for bronchiolitis
palivizumab
-targets RSV
-monthly injection
-given to high risk babies (ex-preamture, congential heart disease)
signs of poor ventilation in a child
use capilary blood gas
rising pCO2
Falling pH- respiratory acidosis (type 2 resp failure)
first line ventilatory support for a child struggling to ventilate themselves
high flow humidified O2
-tight nasal canal
Brand names- Airvo and Optiflow
-adds positive end-expiratory pressure to maintain airways at end of expiration
second line ventilatory support for a child struggling to ventilate themselves
continous positive airway pressure -CPAP
sealed nasal cannula performs similarly to.a high flow nsal canal but at higher and more controlled presures
third line ventilatory support for a child struggling to ventilate themselves
intubation and ventilation
-endotracheal tube into trachea
-fully ocntrol ventilation
