Lightning Learning: Bronchiolitis

Lightning Learning: Bronchiolitis

“Tis the season to be bronchy!”
👶💨
— advice is based on local guidelines & procedures

STOP!

Bronchiolitis is the most common cause of hospitalisation for children under 1 year – increasing yearly!

Remember…

  1. The majority can be managed at home.

  2. No investigations are routinely needed.

  3. No medications are routinely required.

  4. Doing nothing is ok! (if symptoms mild)

  5. Good advice is everything.

LOOK

1) Bronchiolitis is a Clinical Diagnosis

  • Typical history (under 12 months) – 2 to 3 days of cold, cough and mild fever

  • Typical examination – Coryzal, widespread crackles and wheeze

  • Typical situation – feeding little and often, happy, wetting nappies

If atypical, read… #SimBlog: If You Focus On The Problem

2) Mild Severity = ?discharge

Indicated by:

  • O2 saturations consistently above 92% (see discussion below)

  • No cyanosis, no apnoeas, normal behaviour

  • Nil to mild recessions, nil to mild tachypnoea

  • Feeding adequately, more than 50% of normal*

  • Wetting nappies adequately*

*see #LightningLearning: Feeding Assessment (coming soon)

3) No Risk Factors = ?discharge

Risk factors for rapid deterioration:

  • A baby less than 10 weeks old

  • Ex-prematurity – chronic lung disease

  • Congenital heart disease

  • Chronic illness (e.g. neurological, immune compromised)

  • Congenital or genetic syndrome

4) Safety Net Carefully

This is THE most important bit, their baby could get worse. Give EVERY parent a leaflet and EXPLAIN it.

IF IN DOUBT OR THE PARENTS ARE UNHAPPY, GET A SENIOR OPINION!

Sim Blog: 'Tis the Season to be Bronchy

Sim Blog: 'Tis the Season to be Bronchy

Sim Blog: Facing Your Demons

Sim Blog: Facing Your Demons