BRONCHIOLITIS 

Valeria Wu, MD

Presentation: Kids < 2, commonly caused by respiratory syncytial virus / rhinorrhea, wheezing, crackles, tachypnea, cough, apnea 

Diagnosis: Clinical. 

Treatment: Nasal suction with saline. Monitor O2. Hydrate. If need oxygen, NPPV, consider high flow nasal cannula (better tolerated) 

Take note: Symptoms can last weeks, usually worst in first week.  Take into consideration symptom severity and patient history for disposition.  

References:

Freire G, Shefrin A, Zemek R. Wheezing in Infants and Children. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw-Hill; Accessed October 29, 2020. 

Parikh RR, Huang CJ. Stridor and Drooling in Infants and Children. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw-Hill; Accessed October 29, 2020. 

Photo: Case courtesy of Dr Jeremy Jones, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/35357">rID: 35357</a>