Pediatrics

Baby 3 months old with bronchiolitis symptoms and poor feeding.

O2 89%. What is the management?

  1. A Low flow oxygen with feeding support and nasal suctioning if needed Correct answer
  2. B High flow nasal cannula with IV fluid
  3. C didn't recall
  4. D didn't recall

Explanation

Core Concept: Acute bronchiolitis is a viral lower respiratory tract infection (most commonly RSV) causing inflammation and mucus plugging in the small airways of infants.

Clinical Presentation:

  • Rhinorrhea, cough, tachypnea, wheezing, retractions, and poor feeding due to respiratory distress.

Diagnosis:

  • First-line: Clinical diagnosis.
  • Gold Standard: Clinical assessment of work of breathing and hydration status; viral testing is optional.

Management:

  • Acute: Supportive care is the mainstay. For an infant with hypoxia (SpO2 89%) and poor feeding, the appropriate management is low flow oxygen to maintain SpO2 > 90%, feeding support (via NGT or IV fluids if oral feeding is unsafe), and nasal suctioning to clear upper airway secretions.
  • Long-term: Bronchodilators and corticosteroids are not routinely recommended.

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