Lower Respiratory Tract Infection
Most common lower respiratory tract infection in children under 2 years old.
tachypnoea, overinflation of chest, retractions, wheezes, crackles
Bronchodilators; no clinical benefit and some indication that may cause clinical deterioration in arterial oxygen saturations
Adrenaline; could help in acute severe case, particularly as a bridge until further support can be obtained.
Steroids; not recommended in any form.
Antibiotics; not routinely used unless high index of suspicion of secondary bacterial infection.
Oxygen; only for oxygen saturations below 90%
IV fluids; as needed
Feeding; PO intake should be held if child is breathing greater than 60 times a minute.
RSV symptoms are rhinorrhea, nasal congestion, cough and fever
Disease process usually runs 10-14 days with days 3-5 having the worst symptoms.
40% of all RSV progresses to bronchiolitis.
Treatment for RSV is same as for bronchiolitis.
REFERENCE: AAP subcommittee on Diagnosis and Management of Bronchiolitis. Pediatrics 2006 Oct;118: 1774-93
RSV: Management of the acute episode. Pediatric Respiratory Reviews; 2000: 215-220.
For more information, please contact:
Jason Herold, Pediatric Transport Coordinator
Georgia Regents Medical Center