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::* Clinicians should not administer systemic corticosteroids to infants with a diagnosis of bronchiolitis in any setting. | ::* Clinicians should not administer systemic corticosteroids to infants with a diagnosis of bronchiolitis in any setting. | ||
::* Clinicians should not administer antibacterial medications to infants and children with a diagnosis of bronchiolitis unless there is a concomitant bacterial infection, or a strong suspicion of one. | ::* Clinicians should not administer antibacterial medications to infants and children with a diagnosis of bronchiolitis unless there is a concomitant bacterial infection, or a strong suspicion of one. | ||
::* Nebulized hypertonic saline should not be administered to infants with a diagnosis of bronchiolitis in the emergency department. | |||
::* Clinicians should not use chest physiotherapy for infants and children with a diagnosis of bronchiolitis. | |||
'''Prophylaxis''' | '''Prophylaxis''' | ||
:* | :* Regimen: [[Palivizumab]] (15 mg/kg/dose) during the respiratory syncytial virus season to infants who qualify for palivizumab in the first year of life. | ||
:: Note | :: Note | ||
::* Clinicians should administer palivizumab during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity defined as preterm infants <32 weeks 0 days’ gestation who require >21% oxygen for at least the first 28 days of life. | |||
::* Clinicians should not administer palivizumab to otherwise healthy infants with a gestational age of 29 weeks, 0 days or greater. | ::* Clinicians should not administer palivizumab to otherwise healthy infants with a gestational age of 29 weeks, 0 days or greater. | ||
::* All people should disinfect hands before and after direct contact with patients, after contact with inanimate objects in the direct vicinity of the patient, and after removing gloves. | ::* All people should disinfect hands before and after direct contact with patients, after contact with inanimate objects in the direct vicinity of the patient, and after removing gloves. | ||
::* All people should use alcoholbased rubs for hand decontamination when caring for children with bronchiolitis. When alcoholbased rubs are not available, individuals should wash their hands with soap and water. | ::* All people should use alcoholbased rubs for hand decontamination when caring for children with bronchiolitis. When alcoholbased rubs are not available, individuals should wash their hands with soap and water. | ||
::* Clinicians should counsel caregivers about exposing the infant or child to environmental tobacco smoke and smoking cessation when assessing a child for bronchiolitis. | ::* Clinicians should counsel caregivers about exposing the infant or child to environmental tobacco smoke and smoking cessation when assessing a child for bronchiolitis. | ||
Revision as of 18:59, 16 June 2015
Bronchiolitis
Treatment
- Preferred regimen:
- Note[1]
- Clinicians should administer nasogastric or intravenous fluids for infants with a diagnosis of bronchiolitis who cannot maintain hydration orally
- Clinicians should not administer albuterol (or salbutamol) to infants and children with a diagnosis of bronchiolitis.
- Clinicians should not administer epinephrine to infants and children with a diagnosis of bronchiolitis.
- Clinicians should not administer systemic corticosteroids to infants with a diagnosis of bronchiolitis in any setting.
- Clinicians should not administer antibacterial medications to infants and children with a diagnosis of bronchiolitis unless there is a concomitant bacterial infection, or a strong suspicion of one.
- Nebulized hypertonic saline should not be administered to infants with a diagnosis of bronchiolitis in the emergency department.
- Clinicians should not use chest physiotherapy for infants and children with a diagnosis of bronchiolitis.
Prophylaxis
- Regimen: Palivizumab (15 mg/kg/dose) during the respiratory syncytial virus season to infants who qualify for palivizumab in the first year of life.
- Note
- Clinicians should administer palivizumab during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity defined as preterm infants <32 weeks 0 days’ gestation who require >21% oxygen for at least the first 28 days of life.
- Clinicians should not administer palivizumab to otherwise healthy infants with a gestational age of 29 weeks, 0 days or greater.
- All people should disinfect hands before and after direct contact with patients, after contact with inanimate objects in the direct vicinity of the patient, and after removing gloves.
- All people should use alcoholbased rubs for hand decontamination when caring for children with bronchiolitis. When alcoholbased rubs are not available, individuals should wash their hands with soap and water.
- Clinicians should counsel caregivers about exposing the infant or child to environmental tobacco smoke and smoking cessation when assessing a child for bronchiolitis.
- ↑ Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM; et al. (2014). "Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis". Pediatrics. 134 (5): e1474–502. doi:10.1542/peds.2014-2742. PMID 25349312.