None of these are going to help or change the course of the illness.
But these 3 things CAN help.
Firstly, oxygen supplementation can help babies with low sats (around 92% depending on guidelines)
Secondly, high flow can help provide extra support for babies with severe work of breathing
Thirdly, some babies need help with feeds (NG or IV).
Tip #4: Know your discharge criteria
The easiest way to do this?
Ensure your patient:
• Isn't having apnoeas
• Feeds well
• Has wet nappies
• Has stable oxygen sats
• Has normal/mild respiratory effort
With all these in place you will be making a safe discharge.
Tip #5: Safety net well
Finally, this is the most underrated advice of all
There's no point sending a family home if they aren't comfortable, confident + know when to return.
We know that bronchiolitis may get worse before it gets better.
Make sure the parents know that too.
Make sure parents know what to look out for:
• Worsening work of breathing
• Feeding problems
• Lethargy
• Reduced wet nappies
• Apnoeas
They need to be able to return + feel happy to do so
It's also a good time to discuss smoking cessation.
Don’t avoid the conversation.
TL;DR - 5 top tips on managing bronchiolitis to ensure you discharge safely and appropriately.
• Tip #1: Assess the feeding
• Tip #2: Know the high risk babies
• Tip #3: The drugs don't work (mostly)
• Tip #4: Know your discharge criteria
• Tip #5: Safety net well
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