Bronchiolitis Flashcards
What is bronchiolitis?
Inflammation and infection in the bronchioles - small airways of lungs
most common cause
RSV
when is bronchiolitis most common?
winter
Usual age of children affected
under 1 year - most common in those under 6 months
babies up to 2yrs if premature with chronic lung disease
what is heard on auscultation?
harsh breath sounds, wheeze and crackles
presentation
coryzal symptoms - viral URTI (runny nose, sneeze, mucus, watery eyes)
SOB, tachypnoea, poor feeding, mild fever, apnoeas and wheeze/crackles
Signs of respiratory distress
raised resp rate use accessory muscles intercostal and subcostal recessions nasal flaring head bobbing tracheal tugging cyanosis
What is wheezing?
whistling sound caused by narrowed airways typically heard on expiration
What is grunting?
caused by exhaling with the glottis partially closed to increase positive end expiratory pressure
What is stridor?
high pitched inspiratory noise caused by obstruction of upper airway eg croup
Timeline of bronchiolitis
URTI + coryzal symptoms
half get better, half chest symptoms after 1-2 days
worst on day 3-4
last 7-10 days and most recover in 2-3 weeks
what are children who had bronchiolitis as infants more likely to have during childhood?
viral induced wheeze
Reasons for admission
under 3 months, premature, CF, downs syndrome etc.
50-75% normal milk intake
sats <82%, RR >70
apnoeas
management
usually supportive - adequate intake
saline nasal drops
oxygen
Assessing ventilation - signs of poor ventilation
rising PCO2
falling pH - respiratory acidosis
type 2 resp failure
