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Bronchiolitis (7301)

Bronchiolitis (7301) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Pediatrics, Parenting

7301





Bronchiolitis

Bronchiolitis is a viral infection of the lower
breathing passages. It is a very common
illness in infants and young children less
than 2 years of age. Bronchiolitis occurs
most often between November and April. It
affects the entire breathing passageways,
including the bronchioles, which are the
smallest air passages in the lungs. Infection
causes inflammation, which leads to partial
or complete blockage of air passages.

What causes bronchiolitis?
Several different viruses that cause colds
and flu-like illness can cause bronchiolitis.
Respiratory Syncytial virus (RSV) is the
most frequent cause of bronchiolitis. Young
children catch these viruses from close
contact with older children, family
members, or others who are sick. The virus
is spread when a sick person coughs or
sneezes near another person’s face. The
virus can also be spread by hands that touch
contaminated objects and then touch the
eyes or nose. The illness begins about 3-7
days later.

How will you know if my child has
bronchiolitis?
Bronchiolitis is often diagnosed by
information from parents and examining the
child. Symptoms are classic in how they
start and progress. X-rays and labs may be
ordered, but often are not needed.



What symptoms will my child have if
infected with bronchiolitis?
Bronchiolitis usually begins as a cold.
Often, symptoms include
 Fever
 Runny nose or nasal stuffiness
 Mild cough
 Less appetite
 Mild problems breathing
 As the virus spreads to the small
airways of the lungs (1-3 days later),
a whistling sound called wheezing
may be heard when the child
breathes out.

Children may have
 Rapid breathing (60-80 times per
minutes)
 Mild to severe breathing problems
 Constant coughing
 Problems eating
 Babies who were born early or who
are less than 2 months old may stop
breathing for short periods of times
at the start of the illness. This is
known as apnea.

In healthy infants and children, bronchiolitis
will usually go away on its own.
Bronchiolitis is most often mild. The child
often gets better after 3-4 days. Sometimes,
the infection is more serious and the child
needs to be hospitalized.




How will my child be cared for in the
hospital?
Because the virus that causes bronchiolitis
can be spread to others, your child will be
put into an isolation room. A sign will be
posted on the door to remind everyone of
things to do to prevent the spread of
infection.

Hand washing: Everyone going into and
out of your child’s room must wash their
hands. Staff must wash their hands before
and after touching your child or any object
in the room. Hand washing is the best way
to prevent the spread of infection.

Gowns, gloves, and mask: These items are
required for all persons who go into your
child’s room. They prevent contact with
infected items and secretions. Items should
be left in the room when no longer needed.

Treatment in most cases involves treating
symptoms related to the infection. We also
make sure your child receives enough
oxygen and fluids.

Feeding: Your child will be given plenty of
fluids. Most babies are offered formula or
breast milk. If your child is having trouble
eating due to breathing problems, feedings
may be decreased or stopped for a short
time. If feedings are decreased or stopped
briefly, fluids may be given thru a tube in
the nose (nasogastric or NG tube) or through
a small tube that is put into a vein (an IV).

Suctioning the nose: When babies have
bronchiolitis, their noses often get plugged.
This can make it hard to breathe while
eating. It helps to suction the nose before
feeding. It also helps to suction before
breathing treatments and any time the child
is having more trouble breathing. It also
helps to suction before naps or bedtime.

If the mucus is very thick, it helps to give a
few saline drops into the nose before
suctioning. While in the hospital, it will be
important to learn how to use a bulb syringe
to suction the nose before you go home.

You can buy saline nose drops in most drug
stores. If you choose, you can make the
drops at home by adding ¼ teaspoon salt to
8 ounces (1 cup) of warm (not hot) water.
Stir to dissolve the salt. Fresh saline drops
should be made daily.

To use a bulb syringe
1. Place the infant on his/her back.
2. Use a clean eye dropper or clean
cotton ball to place 2-4 drops of
saline solution in each nostril.
3. Let the drops stay in the nose for
one minute.
4. Squeeze and hold the bulb syringe
to remove the air.
5. Gently insert the tip of the bulb
syringe into one nostril.
6. Release the bulb. Suction will
draw mucus out of the nostril into
the bulb.
7. Squeeze the mucus out of the bulb
into a tissue.
8. Repeat the suction process several
times in each nostril until most of
the mucus is removed.
9. Wash the dropper and bulb syringe
in warm, soapy water. Rinse well
and squeeze to remove any water.
10. The bulb syringe can be used 2-3
times per day as needed to remove
mucus. This is best done before
feedings. The saline and suction
process can cause vomiting after
feedings.

Oxygen: Your child’s doctor, nurse, and
Respiratory Therapist (RT) will check to see
how your child is breathing. This will help
to decide if your child needs oxygen, or if
oxygen being used can be decreased or
stopped. Your nurse and RT will teach you
how to look for signs of breathing problems.

A machine called a pulse oximeter may be
used to help the breathing checks. Your
child does not need to be connected to this

machine all of the time. We can check how
hard your child is working to breath by
watching him or her.

Laboratory and other tests: Bronchiolitis
most often does not require tests. There
may be times when a blood test or chest x-
ray is ordered. If these tests are needed,
their purpose will be explained to you.

Medicines: Bronchiolitis often goes away
by itself. It is not always helpful to give
medicines in most cases. If medicines are
used, they may include:
 Albuterol to help make breathing
easier if we think the airway muscles
are having some spasm.
 An antibiotic is used if your child
has an infection such as an ear
infection or pneumonia.
 Tylenol® or ibuprofen is used if
your child is uncomfortable or has a
fever.

When can my child be discharged from
the hospital?
The normal hospital stay is 3-5 days. Your
child may go home when
 Your child is improving
 Your child is breathing more easily
than on admission
 Oxygen saturations are greater than
or equal to 94% on room air while
awake
 Your child is eating well enough to
avoid dehydration
 Any needed medicines can be given
at home
 When your provider is comfortable
that your child is doing well
 When you are comfortable caring for
your child. This includes how to use
the bulb syringe, how to recognize
breathing problems and how to know
your child is getting enough fluids.

What should I expect after discharge
from the hospital?
It is normal for your child to have symptoms
for up to a month. Wheezing should get
better within a week or so. The stuffy nose
and cough may last for another 1-2 weeks.
Sleeping and eating routines may not return
for up to a week.

When should I call my doctor or nurse
after we are home?
 Your child is very sleepy, weak or
looks very ill
 Your child has a fever (temperature
greater than 100.4 θ F or 38 θC),
especially if your child is younger
than 90 days old
 Your child is having problems
feeding
 Your child is having fewer wet
diapers than usual, the lips and
mouth are dry, there are no tears with
crying, the eyes appear sunken and
dark, or the soft spot on top of your
infant’s head is sunken
 You have any questions or concerns

Seek medical help right away if your child
develops worsening bronchiolitis. These
symptoms include:
 Breathing that is not improving
 Pale or blue-tinged skin (cyanosis)
 Severe coughing episodes
 Severe sucking in of the skin around
the ribs or base of the throat
(retractions)
 If your child stops breathing

Parents should not try to drive their child to
the hospital if the child is severely agitated,
blue, struggling to breathe, stops breathing,
or is excessively drowsy (lethargic).
Emergency Medical Services should be
called by dialing 911.


Reminders
 Be sure no one smokes in the house.
Smoke can be very harmful for
babies, especially when they have
bronchiolitis.
 Wash your hands often, mainly
before and after handling your child.
 Do not give decongestant nose
drops, antihistamines, or cold
medicines to your child unless told
to do so by your doctor.
 Never give aspirin unless told to do
so by your doctor.
 Avoid contact with people who have
infection. You don’t want to re-
infect your child.
 There is no vaccine to prevent
against the most common causes of
bronchiolitis. The flu vaccine is
recommended for all children ages 6
months through 18 years, and for
household contacts of children ages
birth thru 59 months.
 Keep your child home from school
or daycare until he or she is better.















Related Health Facts for You topics:
Isolation Precautions for Pediatric Patients (6415)
Isolation Precautions for Pediatric Patients (Spanish version, 7187)
Respiratory Syncytial Virus (4319)
The Common Cold and your Child (5072)
The Common Cold and your Child (Spanish version, 5868)

The Spanish.version of this Health Facts for You # 7342

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 8/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7301