Bronchiolitis

Bronchiolitis

EMKF

Bronchiolitis Treatment

What are the cornerstones for bronchiolitis treatment? Supportive care! This means ensuring adequate hydration and oxygenation. A limited amount of suctioning to clear the nares might be beneficial. Supplemental oxygen may be necessary if oxygen saturations are < 90% persistently. Antipyretics (acetaminophen or ibuprofen) for infants with high fever are often useful adjuncts for treatment and can reduce irritability.

 

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Bronchiolitis guidelines

EMKF

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Bronchiolitis Treatment

What are the cornerstones for bronchiolitis treatment? Supportive care! This means ensuring adequate hydration and oxygenation. A limited amount of suctioning to clear the nares might be beneficial. Supplemental oxygen may be necessary if oxygen saturations are < 90% persistently. Antipyretics (acetaminophen or ibuprofen) for infants with high fever are often useful adjuncts for treatment and can reduce irritability.

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Bronchiolitis

EMKF

  • Chest x-rays do not predict disease severity and might lead to unnecessary antibiotic usage.
  • Viral testing doesn’t change management and doesn’t predict risk of complications.
  • Chest PT makes us feel better but not the patients.
  • Hypertonic saline has not been proven effective in the ED although it may shorten length of stay when used as an inpatient. However, recently there were two RCTs that showed conflicting results on the effectiveness of hypertonic saline in the ED.
  • There isn’t much benefit to routine continuous pulse oximetry, as its use can vary and may lead to increased hospitalization rates.
  • Supplemental oxygen isn’t indicated unless said pulse oximetry is lower than 90%.