Bronchiolitis

Question 1

Bronchiolitis

Answer 1

Wheezing in a child <12/12 mostly can be up to 2years
Breathing difficulties 
Aponea +/-
\+/- feeding difficulties 
75% RSV
Others viruses

Question 2

Presentation

Answer 2

Usually 3-6 days after the URTI starts 
Present with increasing wheezing sob feeding and cough 
Management 
Exclude other causes
Assess the severity 
Consider high risk kids

Question 3

High risk children

Answer 3

ATSI
<10/52 
Prem born <37weeks
Smoking household 
Chronic lung/heart disease 
BF <2/12
Immunodeficiency

Question 4

Grade bronchiolitis

Answer 4

Mild no aponea feeding normal pO2 >92% in room air
Moderate mild aponea some feeding difficulties, may appear sob
Mild hypoxia easily fixed with oxygen

Severe. Tired cant or wont feed/ O2 <92 and difficult to get it up
Sever resp distress
+/- freq and severe aponea

Question 5

Management of mild Bronchiolitis

Answer 5

Observe for 4 hours check they are stable
Home regular feeds
Review in 2-3 days

Question 6

Moderated Bronchiolitis

Answer 6

Admit
O2 to stay >92% observe give oxygen if necessary
Freq feeds / NG observe closely ( iv fluids as good as NG)
Watch fluid balance

Question 7

Severe Bronchiolitis

Answer 7

Admit ICU
Oxygen and IV fluids

Oxygen can be given via nasal prongs
Humidified nasal prongs
Face mask
Or CPAP

Question 8

Steroids for Bronchiolitis

Answer 8

Steroids and bronchodilator meds NO USE
Antivirals NO use
Oxygen and fluids and support make a difference