Title: Respiratory season is here…<br/>Author: Jennifer Guyther<br/><a href='http://umem.org/profiles/faculty/314/'>[Click to email author]</a><hr/><p>
        <span style="font-family: arial, sans-serif; font-size: small;">Now that respiratory season is upon us, we are faced with an </span><span style="font-family: arial, sans-serif; font-size: small;">increasing number of bronchiolitis children.  The updated clinical </span><span style="font-family: arial, sans-serif; font-size: small;">practice guidelines for managing these kids were recently published </span><span style="font-family: arial, sans-serif; font-size: small;">and emphasize supportive care only.</span><br style="font-family: arial, sans-serif; font-size: small;" />
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        <span style="font-family: arial, sans-serif; font-size: small;">Some of the key points:</span></p>
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        <span style="font-family: arial, sans-serif; font-size: small;">-When clinicians diagnose bronchiolitis on the basis of history and </span><span style="font-family: arial, sans-serif; font-size: small;">physical examination, radiographic or laboratory studies should not be </span><span style="font-family: arial, sans-serif; font-size: small;">obtained routinely.</span><br style="font-family: arial, sans-serif; font-size: small;" />
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        <span style="font-family: arial, sans-serif; font-size: small;">-Medications such as albuterol, nebulized epinephrine or steroids </span><span style="font-family: arial, sans-serif; font-size: small;">should not be administered routinely in children with a diagnosis of </span><span style="font-family: arial, sans-serif; font-size: small;">bronchiolitis.</span><br style="font-family: arial, sans-serif; font-size: small;" />
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        <span style="font-family: arial, sans-serif; font-size: small;">-Nebulized hypertonic saline should not be administered to infants </span><span style="font-family: arial, sans-serif; font-size: small;">with a diagnosis of bronchiolitis in the emergency department</span><br style="font-family: arial, sans-serif; font-size: small;" />
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        <span style="font-family: arial, sans-serif; font-size: small;">-Clinicians may choose not to administer supplemental oxygen if the </span><span style="font-family: arial, sans-serif; font-size: small;">oxyhemoglobin saturation exceeds 90% in infants and children with a </span><span style="font-family: arial, sans-serif; font-size: small;">diagnosis of bronchiolitis</span><br style="font-family: arial, sans-serif; font-size: small;" />
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        <span style="font-family: arial, sans-serif; font-size: small;">-Clinicians may choose not to use continuous pulse oximetry for </span><span style="font-family: arial, sans-serif; font-size: small;">infants and children with a diagnosis of bronchiolitis.</span></p>
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        <span style="font-family: arial, sans-serif; font-size: small;">Check out the full guidelines for the quality of evidence and </span><span style="font-family: arial, sans-serif; font-size: small;">rational behind these recommendations.</span></p>
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        <span style="font-family: arial, sans-serif; font-size: small;">The <strong>bottom line</strong> is that not much really works, and we just need to </span><span style="font-family: arial, sans-serif; font-size: small;">support their respiratory effort and ensure hydration.</span></p>
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        <span style="font-family: arial, sans-serif; font-size: small;">Ralston et al.  Clinical Practice Guideline: The diagnosis, Management </span><span style="font-family: arial, sans-serif; font-size: small;">and Prevention of Bronchiolitis.  Pediatrics 2014; 134: e1474-e1502.</span></p>
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