Respiratory smooth muscle more mature after 5 months old o Younger the pt less

Respiratory smooth muscle more mature after 5 months

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Respiratory smooth muscle more mature after 5 months old o Younger the pt, less mature, worse off they are if they get respiratory infection, esp if premature or post-premature baby Bronchiolitis Inflammation , mucus filling of smallest airways Caused by bacteria or virus, most often by respiratory syncytial virus ( RSV ) Highly contagious Increases mucus production Cough – to clear airways Fever Irritability, loss of appetite – dehydration!! Wheezing, coarse lung sounds -mucus & wet airways Bronchiolitis: Respiratory Syncytial Virus Season is October-March Generally, the younger the child, the more severe the case Severity can range from mild cold-like symptoms to ICU, respiratory failure, ventilator Chronic conditions = worse – asthma, heart conditions Protection: breast feeding Symptoms can linger up to a month Hospitalization can last weeks Virus can live on surfaces for over 6 hours Infectivity: don’t always get infected when you intro to your body o RSV = 79% infectivity Isolation: Contact / Droplet Bronchiolitis: Respiratory Syncytial Virus
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RSV is particularly dangerous for: Age < 24 months History of chronic lung disease Congenital heart disease Premature birth Synagis is an RSV immunoglobulin (antibodes) for those at high risk Given monthly – to at risk infants to help protect from RSV – not vaccine, body doesn’t form defense (not acquired) Very expensive ($1500) o Premie getting sick, ICU chance is higher & COST is higher… Bronchiolitis: Diagnosis Nasopharyngeal culture o Respiratory viral panel Chest x-ray o Hyperinflation o Atelectasis Bronchiolitis/RSV Treatment antibiotics, if indicated (usually viral) Frequent saline (loosen secretions, protect mucosa), suction Oxygen, if indicated NC or intubation is needed IVFs/tube feeding, if indicated Respiratory support – vent, face mask, blow by Antipyretics – Tylenol, motrin for comfort Bronchodilators – albuterol – open airways o Nebulizer or Metered Dose Inhaler Decongestants? Cough syrups? o Only for ages > 6 yr o Honey for cough suppressant only for >1yr Prevention Which of the following interventions would be inappropriate for a baby with bronchiolitis caused by RSV? A. Frequent saline and suction B. Nutrition via NG C. Large, bolus feeds – vomit – smaller more frequent feedings! D. Oxygen administration Pneumonia Many times, pneumonia with bronchiolitis Inflammation or infection of the bronchioles and alveolar spaces of the lungs Can be viral or bacterial or due to aspiration – feeding tubes pt Cause fever, cough, abdominal and chest tightness/pain, coarse lung sounds Pneumonia: Diagnosis Based on history and physical CXR may show areas of consolidation
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Pneumonia: Treatment Oxygen Humidification Hydration Antibiotics Antipyretics Prevention Bronchodilators Pulmonary Toileting – hygiene, cough & deep breathe, incentive spirometer (suck like big milk shake) BUBBLES!
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