Bronchiolitis - NICE CKS guidelines Flashcards

1
Q

What is the age range primarily affected by bronchiolitis as per NICE guidelines?

A

Bronchiolitis occurs in babies and children under 2 years of age, most commonly in the first year of life, peaking between 3 and 6 months.

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2
Q

What symptoms define bronchiolitis according to NICE guidelines?

A

Diagnosis of bronchiolitis should be considered if the baby or child has a coryzal prodrome lasting 1 to 3 days, followed by persistent cough and either tachypnoea or chest recession (or both) and either wheeze or crackles on chest auscultation (or both).

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3
Q

What additional symptoms are common in bronchiolitis?

A

Fever (in around 30% of cases, usually less than 39°C) and poor feeding (typically after 3 to 5 days of illness).

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4
Q

When should babies and children with bronchiolitis be immediately referred for emergency hospital care?

A

Immediate referral is necessary if they have apnoea (observed or reported), look seriously unwell to a healthcare professional, have severe respiratory distress like grunting or marked chest recession, or if their respiratory rate is over 70 breaths/minute or they have central cyanosis.

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5
Q

What are the oxygen saturation thresholds for hospital referral as updated in 2021?

A

Consider referral to hospital if persistent oxygen saturation is less than 92% when breathing air.

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6
Q

What management strategies are recommended for bronchiolitis?

A

Do not use antibiotics, hypertonic saline, nebulised adrenaline, salbutamol, montelukast, ipratropium bromide, or corticosteroids. Oxygen supplementation should be given if saturation is persistently below 90% for children aged 6 weeks and over, or below 92% for babies under 6 weeks or those with underlying conditions.

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7
Q

What are the guidelines for the discharge of patients with bronchiolitis?

A

Discharge should be considered when they are clinically stable, taking adequate oral fluids, and have maintained appropriate oxygen saturation levels for 4 hours, including a period of sleep.

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