The Resus Room Bronchiolitis; Roadside to Resus
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Jan 15, 2025 This discussion tackles bronchiolitis, a prevalent respiratory illness in kids, shedding light on its definition and clinical presentation. The hosts debunk the myth that bronchodilators are effective, advocating for oxygen therapy and proper assessment instead. They also stress the importance of following NICE guidelines and highlight necessary care strategies in emergency settings. Practical insights into managing respiratory distress in young patients are provided, along with guidance on discharge criteria and family support during recovery.
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What Bronchiolitis Really Is
- Bronchiolitis is a viral inflammation of the small bronchioles most commonly caused by RSV.
- It predominantly affects children under two, especially under one year, with clear seasonal peaks.
Make It A Clinical Diagnosis
- Diagnose bronchiolitis clinically using prodrome, persistent cough, tachypnoea or chest recession, plus wheeze or crackles on exam.
- Follow NICE criteria rather than routine imaging or labs for diagnosis.
Two-Phase Pathophysiology
- Bronchiolitis has an early upper-airway phase then a later lower-airway phase with mucus, cell sloughing and plugging.
- Mucus plugging causes air-trapping, hypoxaemia and possible hypercarbia driving tachycardia and tachypnoea.