Paediatric Bronchiolitis Scenario

What components are included in your initial paediatric assessment triangle?

You quickly assess the patient, gain basic observations, and some important history.

Observations are currently HR 175, RR 60, Sp02 91%, Temp 38.5, BM 4.5. He is alert, has a wet cough, has bilateral wheeze with crackles on auscultation and noteworthy moderate subcostal recession. His work of breathing seems forced so you are quite concerned. He has coryzal symptoms, he currently isn’t feeding as well and is only taking small amounts whilst breastfeeding. He was full term with no complications. No past medical history or allergies and is currently fully immunised. His mother has reported his nappies have been normal today.

What is your primary differential for this patient?

According to NICE guidelines, a diagnosis of bronchiolitis can be made if a child under 2 years of age presents with a prodromal coryzal symptom followed by what other three symptoms?

What is this patients POPS score?

Assuming a bronchiolitis diagnosis was correct, what treatment would you consider for this patient?

At what point should you consider giving antipyretics to paediatric patients?

What indicators may alert you to consider a pneumonia diagnosis rather than solely bronchiolitis? (tick all that apply)

The patient is moved into the Ambulance and you make your way to hospital giving a pre-alert on route. What further risk factors should clinicians consider that will lower the threshold of transporting the patient to hospital? (tick all that apply)

What red flag features do JRCALC and NICE guidelines recommend requires hospital admission for bronchiolitis? (tick all that apply)

When considering reduced oral intake in paediatrics, NICE guidelines recommend hospital admission if reduced to what level? (Considering risk factors and using clinical judgement)

In what age range would you most likely see bronchiolitis patients?

If a fever has been recorded for 5 days and over, a patient should be referred for further medical assessment?

Which pathogen is predominantly responsible for bronchiolitis infections?

If discharging a paediatric bronchiolitis patient, what factors should you consider to ensure the patient is appropriately safety netted? (tick all that apply)

90% of Bronchiolitis patients will resolve their cough within what time period?