Bronchiolitis RSV respiratory syncytial virus Flashcards
define bronchiolitis?
acute inflammation of bronchioles in infants (under 1 year old)
most common cause?
respiratory syncytial virus
how does mum protect child from RSV?
Maternal IgG protects newborns from RSV
what are bronchioles?
small airways
who gets bronchiolitis in terms of age?
Under 1s
is it common?
Very common
when in the year it is most common?
winter
disease course?
Gets worse for 3 days, then static for 3 days, then improves over 1-2 weeks
Other viral causes for bronchiolitis ?
-2
Mycoplasma
adenoviruses
influenza
is this a URTI or LRTI?
starts as URTI, can spread to LRTI
Risk Factors?
-3
Crowded spaces; schools
underlying heart or lung condition; CF
premature birth
advice on how parents can prevent it?
Wash hands, do not share toys, avoid crowded spaces
symptoms?
Coryzal symptoms I Fever Dry cough SOB Eat less – kids do this when ill & sob
Coryzal symptoms means infection is where?
URTI
SOB means infection is where?
LRTI
child eats less tells you what?
they are unwell/ feeling ill
Wheeze caused by what?
airways narrowed
crackles caused by what?
alveoli snapping open
signs on auscultation?
Wheeze
Bilateral fine crackles
how long should any viral fever in a child last?
last 5 days
if a viral fever lasts longer than 5 days what does this tell you?
means something else going on (e.g. 2° bacterial infection)
Signs of Resp Distress in children?
-4
Tachypnoea
Recession
Use accessory muscles
Expiratory grunt
why is mucus made in bronchiolitis?
what sign do you hear because of this?
Inflamed small airways > make mucus
mucus > airways obstructed > hear wheeze
is there fever?
yes
why is premature birth a risk factor?
Premature birth > these babies have bronchopulmonary dysplasia > now any resp infection will be worse
category of diagnosis?
clinical
if resp distress what Ix do you do?
why?
capillary blood gas
check for resp acidosis
is lots of SOB and RDS signs what Ix do you do?
why?
CXR
check pneumonia
can bronchiolitis spread and cause pneumonia?
yes
Ix used to check for RSV?
nasal swab - immunofluorescence on the secretion
do you need Ix to diagnose bronchiolitis?
no
1st line Mx for most kids?
main advice you give to parent?
just support and they will get better by themselves
keep drinking
if child dehydrated or not drinking, what do you do?
IV fluids
if child not eating, what do you do?
oropharynx tube
if child has lots of airway secretions, what do you do?
suction
when do you admit bronchiolitis child to hospital?
-3
Signs of Resp distress
Any apnoea (stop breathing in sleep)
Central cyanosis or < 92 O2 sats
when do you consider admitting bronchiolitis child to hospital?
-2
not E+D
dehydrated
