But, the good news – these guidelines substantially reduce the things you have to remember to do for bronchiolitis. Specifically, the only evidence-supported intervention you have is: supportive care.
Ineffective, or of inadequate risk/benefit, treatments:
- A trial of bronchodilators, such as albuterol or salbutamol.
- Nebulized epinephrine.
- Nebulized hypertonic saline, except possibly those requiring hospitalization.
- Systemic or inhaled corticosteroids.
- Chest physiotherapy.
And, not inconsistent with a recent trial regarding the misleading clinical weight of pulse oximetry, the guidelines state it is reasonable not to perform continuous oximetry on infants and children with bronchiolitis, and set 90% as an acceptable oxygen saturation. Finally, the authors also state routine chest radiography should be avoided, as abnormalities are common in bronchiolitis – thus leading to ineffective, and harmful, antibiotic administration.
Simply put – do no harm!
“Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis”