Bronchiolitis Flashcards Preview

Hugh's MD3 Paediatrics > Bronchiolitis > Flashcards

Flashcards in Bronchiolitis Deck (11)
Loading flashcards...
1
Q

Who usually gets bronchiolitis and when?

A

1 years old and younger

Usually in winter

2
Q

What is the aetiology of bronchiolitis?

A

Majority is viral - RSV, Human rhinovirus

3
Q

How does bronchiolitis present?

A
Hx
- Mild fever
- Cough 
- Wheeze
- Tachypnoea
Ex
- Increased WOB
- Fine inspiratory crackles 
- Wheeze
- Reduced oxygen saturation
4
Q

How is bronchiolitis managed?

A

Usually self limiting
Fluid resus if required
Oxygen +/- high flow

5
Q

How is bronchiolitis investigated?

A
  • Nasopharyngeal aspirate
    ○ For viral immunofluorescence or PCR
    ○ For epidemiology and infection control, no mx implications
6
Q

What are the indications for hospitalisation in bronchiolitis?

A

SASS CICS

  • Severe respiratory distress (grunting, severe recession, RR >70, nasal flaring)
  • Apnoeic episodes
  • Significant hypotonia
  • Survivor of extreme prematurity
  • Congenital heart condition, pre-existing lung disease, or immunodeficiency
  • Intake less than 50% normal
  • Cyanosis
  • Social concerns
7
Q

What is the natural history of bronchiolitis?

A

Self limiting
Symptoms peak at 2-3 days
Usually resolved 7-10 days though cough may persist for weeks

8
Q

What are some markers of severe bronchiolitis?

A

Fatigue

SaO2 less than 90%, particularly if not responding

9
Q

When is it safe to discharge a child with bronchiolitis?

A

Feeding normally

Saturations normal

10
Q

What is the role of salbutamol in bronchiolitis?

A

No role

11
Q

What are some risk factors for bronchiolitis?

A
  • Maternal smoking - the in utero affect more so than inhalation during infancy
  • Pre-term delivery
  • Chronic long term of prematurity
  • Chronic cardiorespiratory diseases
  • Immunodeficiency