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===Bronchiolitis=== | ===Bronchiolitis=== | ||
'''Treatment''' | '''Treatment''' | ||
:: Note<ref name="pmid25349312">{{cite journal| author=Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM et al.| title=Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. | journal=Pediatrics | year= 2014 | volume= 134 | issue= 5 | pages= e1474-502 | pmid=25349312 | doi=10.1542/peds.2014-2742 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25349312 }} </ref> | :: Note<ref name="pmid25349312">{{cite journal| author=Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM et al.| title=Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. | journal=Pediatrics | year= 2014 | volume= 134 | issue= 5 | pages= e1474-502 | pmid=25349312 | doi=10.1542/peds.2014-2742 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25349312 }} </ref> | ||
::* Clinicians should administer nasogastric or intravenous fluids for infants with a diagnosis of bronchiolitis who cannot maintain hydration orally | ::* 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 [[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 [[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 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. | ::* 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. | ::* 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. | :* 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 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 19:04, 16 June 2015
Bronchiolitis
Treatment
- 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.
- Note[1]
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.