Bronchiolitis (peds)

Epidemiology

• Children < 2years old (peak 2-6mo age)
  • 1st episode wheeze
  • seasonal
  • no fam h/o asthma/atopy

Treatment

1. O2 (maintain SaO2 >90%)
2. Racemic Epi neb (or albuterol)
3. No steroids (for 1st episode wheezing)
4. ?Send RSV
5. Suction nares

CXR

1. Mod-severe
2. Recurrance
3. Toxic
4. Sudden deterioration
5. Prolonged course
6. *1st time wheeze

Admit

1. Underlying dz
2. Toxic
3. Unable PO
4. Unresponsive to meds
5. Initial SaO2 <95%
6. Preterm (<34wks)
7. RR >70
8. Atelectasis on CXR
9. Age <4-6wks

DDX

1. Asthma
2. PNA
3. FB
4. Pertusis
5. CHF
6. Cystic fibrosis
7. Vascular ring
8. CA

Source

Adapted from from Rosen, Young, Donaldson