Bronchiolitis

• Most common under a year, peak at 3-4 months old, unlikely in >2 years
• Often preceded by URTI symptoms (rhinorrhea, cough, congestion)
• Most common in winter
• Other family members may have a cold
• Wheeze and crackles, low grade fever, hyper-expanded chest
• Usually resolves in 7-10 days, child is typically most unwell on day 3-5

Treatment

• Oxygen via nasal cannula, escalate as indicated (based on saturations, work of breathing)
• Can benefit from CPAP (for increasing and weaning see neonatal CPAP guideline in Neonatal chapter)
• NGT if severe respiratory distress, or not feeding
• DISCUSS WITH ICU EARLY. These babies have reversible brief illnesses and can respond well with short intubation and ventilation
• Antibiotics are in the majority of cases not indicated usually of viral origin

Usually resolves in 7-10 days, child is typically most unwell on day 3-5