Bronchiolitis (peds): Difference between revisions
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==Background== | ==Background== | ||
*<2yr old (peak 2-6mo age) | *<2yr old (peak 2-6mo age) | ||
*Preemies, neonates, congenital heart dz are at risk for serious disease | |||
* | *Peaks in winter | ||
==Diagnosis== | ==Diagnosis== | ||
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**Fever is usually low-grade or absent | **Fever is usually low-grade or absent | ||
***If high-grade fever consider OM, UTI | ***If high-grade fever consider OM, UTI | ||
*Duration = 7-14d (worst during days 3-5) | |||
==Work-Up== | ==Work-Up== | ||
Revision as of 03:25, 22 June 2011
Background
- <2yr old (peak 2-6mo age)
- Preemies, neonates, congenital heart dz are at risk for serious disease
- Peaks in winter
Diagnosis
- Symptoms
- Rhinorrhea, cough, irritability, periods of apnea (neonates)
- Signs
- Tachypnea, cyanosis, wheezing, retractions
- Fever is usually low-grade or absent
- If high-grade fever consider OM, UTI
- Duration = 7-14d (worst during days 3-5)
Work-Up
- Rapid RSV
- Obtain if <1mo old
- If positive then admit pt
- CXR
- Not routinely necessary
- May lead to unnecessary use of abx (atelectais mimics infiltrate)
- Consider if
- Diagnosis unclear
- Critically ill
- Not routinely necessary
DDx
- Asthma
- PNA
- FB
- Pertusis
- CHF
- Cystic fibrosis
- Vascular ring
- CA
Treatment
- O2 (maintain SaO2 >90%)
- Racemic epi neb
- Only repeat if initial beneficial response
- Suction nares
- No steroids
Disposition
Consider admission for:
- Underlying heart/lung disease
- Preterm (<34wks)
- Age <3months
- Initial SaO2 <92%
- Unable to tolerate PO
See Also
Source
Rosen's, Tintinalli