Bronchiolitis - NICE CKS guidelines Flashcards
What is the age range primarily affected by bronchiolitis as per NICE guidelines?
Bronchiolitis occurs in babies and children under 2 years of age, most commonly in the first year of life, peaking between 3 and 6 months.
What symptoms define bronchiolitis according to NICE guidelines?
Diagnosis of bronchiolitis should be considered if the baby or child has a coryzal prodrome lasting 1 to 3 days, followed by persistent cough and either tachypnoea or chest recession (or both) and either wheeze or crackles on chest auscultation (or both).
What additional symptoms are common in bronchiolitis?
Fever (in around 30% of cases, usually less than 39°C) and poor feeding (typically after 3 to 5 days of illness).
When should babies and children with bronchiolitis be immediately referred for emergency hospital care?
Immediate referral is necessary if they have apnoea (observed or reported), look seriously unwell to a healthcare professional, have severe respiratory distress like grunting or marked chest recession, or if their respiratory rate is over 70 breaths/minute or they have central cyanosis.
What are the oxygen saturation thresholds for hospital referral as updated in 2021?
Consider referral to hospital if persistent oxygen saturation is less than 92% when breathing air.
What management strategies are recommended for bronchiolitis?
Do not use antibiotics, hypertonic saline, nebulised adrenaline, salbutamol, montelukast, ipratropium bromide, or corticosteroids. Oxygen supplementation should be given if saturation is persistently below 90% for children aged 6 weeks and over, or below 92% for babies under 6 weeks or those with underlying conditions.
What are the guidelines for the discharge of patients with bronchiolitis?
Discharge should be considered when they are clinically stable, taking adequate oral fluids, and have maintained appropriate oxygen saturation levels for 4 hours, including a period of sleep.
