Q13: Bronchiolitis
Simon Craig
3 parts
• Table – clinical severity
• List of risk factors for severe complications
• Indications for a chest x-ray
Clinical severity assessment
• 12 marks
• 6 marks for the various clinical factors
• 6 marks for sensible delineation of mild / moderate / severe
Clinical severity assessment
• Clinical factors• Behaviour• Respiratory rate• Accessory muscle use• Feeding• Oxygen• Apnoeic episodes
• NOT• Speech• Wheeze• Crepitations• Cough• Stridor
Risk factors for severe disease
• 6 marks• Young (<6 weeks)• Ex-premature infants• Congenital heart disease• Neurologic conditions• Chronic respiratory illness• Pulmonary hypertension
• Indigenous • Delayed presentation• Failure to thrive / LBW
• NOT• Immunisation status• Diabetes• Smokers at home• <6 months• Sepsis• Dehydration• Pneumothorax• Sats <92% despite
oxygen
Chest x-ray
• 2 marks• Severe illness, eg
CPAP or intubation• Localised signs on
auscultation• Murmer with signs of
congestive cardiac failure
• NOT• Fever• Low saturations• Septic, eg temp >40• SBP <80
• ?inhaled foreign body
Pass mark?
• 12 / 20
Questions?
?