bronchiolitis

Question 1

bronchiolitis - how to assess severity

Answer 1

either mild, moderate or severe
BOARFeed
Behaviour - if its affected, its moderate
O - oxygen > 92% is mild, 90-92 is moderate, < 90 is severe
A - apnoeic episodes. no apnoeas = mild, some apnoeas = mod, many apnoes = severe
R - increased work of breathing. higher = worse
Feed - reduced feeding. if present, its at least moderate

also relevant - assess hydration status
cap refill > 2s
tachypnoea
tachycardia
skin turgor

or
B - behaviour - fatigue or irritability
R - resp rate - marked taccypnoea/bradypnoea
O - Oxygen requirement
N - No apnoeas
C - child working hard to breathe
H - hydration and feeding status

Question 2

bronchiolitis - management

Answer 2

step 1. determine if needs admission (moderate or higher should be admitted)
step 2. maintain hydration and o2 sats - o2 target >92% via nasal prongs
step 3. wait for a better day

Question 3

bronchiolitis - risk factors for serious illness (10)

Answer 3

personal

• indigenous ethnicity
• being born preterm <37weeks
• breastfed for < 2months
• being < 10/52 old

medical

• failure to thrive
• chronic respiratory, neuro or cardiac disease
• immunocompromised
• trisomy 21

environment

• postnatal nicotine exposure
• social factors - geography