Bronchiolitis_flashcards (1)
What is bronchiolitis?
Bronchiolitis is a lower respiratory tract infection affecting babies aged 1-9 months with acute bronchiolar inflammation. Most cases are due to RSV and last 10 days, worsening over 3-5 days.
What are the common causes of bronchiolitis?
RSV, mycoplasma, adenovirus.
What are the differential diagnoses for bronchiolitis?
Pneumonia (if temperature >39°C and/or persistently focal crackles).
What are the symptoms of bronchiolitis?
Preceding coryzal symptoms (including mild fever), dry cough, increasing breathlessness, wheezing, fine inspiratory crackles, feeding difficulties.
What are the risk factors for bronchiolitis?
Premature babies with bronchopulmonary dysplasia, underlying lung disease (e.g., CF), congenital cyanotic heart disease, immunodeficiency.
When should a baby with bronchiolitis be referred?
Referral is required if there is apnoea.
When should referral be considered for bronchiolitis?
Consider referral if respiratory rate >60 bpm, difficulty breast feeding, reduced oral fluid intake to 70%, clinical dehydration, central cyanosis, the child looks seriously unwell to a healthcare professional, reduced oral fluid intake <50%, severe respiratory distress (grunting, marked chest recession, RR>70 bpm, persistent O2 sats <92%).
What are the key investigations for bronchiolitis?
Observation for rash, dehydration status, sunken fontanelle (12-18 months). Bedside observations: pulse oximetry. Respiratory and cardiovascular examination. Check red book. Immunofluorescence of nasopharyngeal secretions for RSV. CXR may show hyperexpansion.
What is the immediate management for bronchiolitis?
Manage in a side room as RSV is highly infectious. Provide humidified oxygen via nasal cannulae or head box if O2 sats <92% (OPTIFLOW). Immediate fluids if dehydrated and nasogastric feeding for reduced fluid intake. Suction for upper airway secretions.
What preventive measures can be taken for bronchiolitis?
Prevention with palivizumab for premature infants, those with lung/heart abnormalities, and immunocompromised infants.
