Respiratory Medicine - Bronchiolitis Flashcards Preview

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Flashcards in Respiratory Medicine - Bronchiolitis Deck (7):
1

What is Bronchiolitis?

1. Bronchiolitis is a condition characterised by acute bronchiolar inflammation.

2. Respiratory syncytial virus (RSV) is the pathogen in 75-80% of cases.

3. NICE released guidelines on bronchiolitis in 2015

2

Epidemiology of Bronciolitis?

1. Most common cause of a serious lower respiratory tract infection in < 1yr olds (90% are 1-9 months,


2. With a peak incidence of 3-6 months).

3. Maternal IgG provides protection to newborns against RSV
higher incidence in winter

3

Causes of Bronciolitis

1. Respiratory syncytial virus (RSV) is the pathogen in 75-80% of cases

2. Other causes: mycoplasma, adenoviruses

3. May be secondary bacterial infection
more serious if bronchopulmonary dysplasia (e.g. Premature), congenital heart disease or cystic fibrosis

4

Clinical signs of Bronchiolitis?

1. Coryzal symptoms (including mild fever) precede:

2. Dry cough

3. Increasing breathlessness

4. Wheezing, fine inspiratory crackles (not always present)

5. Feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission

5

What are the NICE recommendations for immediate referral (usually by 999 ambulance)?

1. Apnoea (observed or reported)

2. Child looks seriously unwell to a healthcare professional

3. Severe respiratory distress, for example grunting, marked chest recession, or a respiratory rate of over 70 breaths/minute

4. Central cyanosis

5. Persistent oxygen saturation of less than 92% when breathing air.

6

NICE recommend that clinicians 'consider' referring to hospital if any of the following apply?

1. A respiratory rate of over 60 breaths/minute

2. Difficulty with breastfeeding or inadequate oral fluid intake (50-75% of usual volume 'taking account of risk factors and using clinical judgement')

3. Clinical dehydration.

7

Investigation and Management?

1. Immunofluorescence of nasopharyngeal secretions may show RSV

2. Humidified oxygen is given via a head box