Clinical update
Bronchiolitis Bronchiolitis is the most common disease that affects the lower respiratory tract. Around one in five babies will develop the condition in their first year of life and it can become a serious illness in a small minority of children. It is caused by a viral infection where small airways in the lungs, known as bronchioles, become inflamed. This inflammation reduces the amount of air entering the lungs and causes breathing difficulties. Up to 3 per cent of children with bronchiolitis will need hospital care. In 2011-12, there were 30,451 secondary care admissions for bronchiolitis in England.
What’s new Draft recommendations to improve the care of babies and young children with a common lung infection have been published by the National Institute for Health and Care Excellence (NICE). The draft guidance says primary care staff, parents and carers all need to recognise the signs of bronchiolitis, which can be mistaken for a cold. In 2009-10, there were 72 recorded deaths of children within 90 days of hospital admission for bronchiolitis in England.
Signs/symptoms The early symptoms of bronchiolitis are similar to those of a common cold, such as a runny nose and cough, according to NHS Choices. Further symptoms then usually develop over the next few days,
Expert comment Clare van Miert, is National Institute for Health Research clinical doctoral research fellow at the Children’s Nursing Research Unit, Alder Hey Children’s Hospital, Liverpool
ALAMY
Essential facts
Find out more NICE draft guidance www.nice.org.uk/ guidance/indevelopment/ GID-CGWAVER136 Bronchiolitis campaign: More than a cold www.morethanacold.co.uk
including a slightly high temperature, a dry and persistent cough, difficulty feeding and rapid or noisy breathing.
Causes/risk factors A child is more at risk of developing severe bronchiolitis if they are aged under two months, have congenital heart disease, were born prematurely or have chronic lung disease. Caused by a viral infection, cases peak over the winter months.
How you can help your patient Become well informed and pass on information to parents. Most children with bronchiolitis can be managed at home and the draft guideline has key safety information. It also sets out recommendations for primary care on when to consider referral to specialist care, such as if a child has rapid breathing (a respiratory rate of over 60 breaths per minute), difficulty breastfeeding or clinical dehydration.
‘Parents need to be aware of the signs and symptoms of worsening bronchiolitis to seek help appropriately – particularly “red flag” symptoms, such as respiratory distress, apnoeas and cyanosis, which will require ambulance transportation to A&E. ‘Parents also need to be aware of the risk factors for more severe illness, for example, prematurity, congenital heart disease and chronic lung disease.
British Lung Foundation www.blf.org.uk Articles from RCN Publishing Preterm infant care Paterson L and Redpath I Nursing Standard (August 2013) rcnpublishing.com/ doi/abs/10.7748/ ns2013.08.27.49.19.s60 Clinical assessment and management of a child with bronchiolitis Kelsall-Knight L Nursing Children and Young People (October 2012) rcnpublishing.com/doi/abs/ 10.7748/ncyp2012.10. 24.8.29.c9339
‘My research found bronchiolitis to be a terrifying experience for those parents with a hospitalised child. Parents received very little information about bronchiolitis before their child became ill. They contrasted this lack of information with other illnesses, such as meningitis and whooping cough. ‘More needs to be done by healthcare professionals in primary and secondary settings to raise awareness of bronchiolitis among parents.’
NURSING :: voluses 29 no 19 :: permission. 2015 19 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 26, 2015. For personal usejanuary only. No7other without Copyright © 2015 RCNi Ltd. All rights reserved.
Bronchiolitis Bronchiolitis is the most common disease that affects the lower respiratory tract. Around one in five babies will develop the condition in their first year of life and it can become a serious illness in a small minority of children. It is caused by a viral infection where small airways in the lungs, known as bronchioles, become inflamed. This inflammation reduces the amount of air entering the lungs and causes breathing difficulties. Up to 3 per cent of children with bronchiolitis will need hospital care. In 2011-12, there were 30,451 secondary care admissions for bronchiolitis in England.
What’s new Draft recommendations to improve the care of babies and young children with a common lung infection have been published by the National Institute for Health and Care Excellence (NICE). The draft guidance says primary care staff, parents and carers all need to recognise the signs of bronchiolitis, which can be mistaken for a cold. In 2009-10, there were 72 recorded deaths of children within 90 days of hospital admission for bronchiolitis in England.
Signs/symptoms The early symptoms of bronchiolitis are similar to those of a common cold, such as a runny nose and cough, according to NHS Choices. Further symptoms then usually develop over the next few days,
Expert comment Clare van Miert, is National Institute for Health Research clinical doctoral research fellow at the Children’s Nursing Research Unit, Alder Hey Children’s Hospital, Liverpool
ALAMY
Essential facts
Find out more NICE draft guidance www.nice.org.uk/ guidance/indevelopment/ GID-CGWAVER136 Bronchiolitis campaign: More than a cold www.morethanacold.co.uk
including a slightly high temperature, a dry and persistent cough, difficulty feeding and rapid or noisy breathing.
Causes/risk factors A child is more at risk of developing severe bronchiolitis if they are aged under two months, have congenital heart disease, were born prematurely or have chronic lung disease. Caused by a viral infection, cases peak over the winter months.
How you can help your patient Become well informed and pass on information to parents. Most children with bronchiolitis can be managed at home and the draft guideline has key safety information. It also sets out recommendations for primary care on when to consider referral to specialist care, such as if a child has rapid breathing (a respiratory rate of over 60 breaths per minute), difficulty breastfeeding or clinical dehydration.
‘Parents need to be aware of the signs and symptoms of worsening bronchiolitis to seek help appropriately – particularly “red flag” symptoms, such as respiratory distress, apnoeas and cyanosis, which will require ambulance transportation to A&E. ‘Parents also need to be aware of the risk factors for more severe illness, for example, prematurity, congenital heart disease and chronic lung disease.
British Lung Foundation www.blf.org.uk Articles from RCN Publishing Preterm infant care Paterson L and Redpath I Nursing Standard (August 2013) rcnpublishing.com/ doi/abs/10.7748/ ns2013.08.27.49.19.s60 Clinical assessment and management of a child with bronchiolitis Kelsall-Knight L Nursing Children and Young People (October 2012) rcnpublishing.com/doi/abs/ 10.7748/ncyp2012.10. 24.8.29.c9339
‘My research found bronchiolitis to be a terrifying experience for those parents with a hospitalised child. Parents received very little information about bronchiolitis before their child became ill. They contrasted this lack of information with other illnesses, such as meningitis and whooping cough. ‘More needs to be done by healthcare professionals in primary and secondary settings to raise awareness of bronchiolitis among parents.’
NURSING :: voluses 29 no 19 :: permission. 2015 19 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 26, 2015. For personal usejanuary only. No7other without Copyright © 2015 RCNi Ltd. All rights reserved.
