Notes – Pediatric Respiratory Distress (Bronchiolitis)

Pediatric Respiratory Distress (Bronchiolitis)

Patient Safety Considerations

  1. Routine use of lights and sirens is not recommended during transport. 

Notes/Educational Pearls

Key Considerations

  1. Suctioning can be a very effective intervention to alleviate distress, since infants are obligate nose breathers
  2. Insufficient data exist to recommend the use of inhaled steam or nebulized saline
  3. Though albuterol has previously been a consideration, the most recent evidence does not demonstrate a benefit in using it for bronchiolitis
  4. Ipratropium and other anticholinergic agents should not be given to children with bronchiolitis in the prehospital setting
  5. Though nebulized hypertonic saline has been shown to decrease hospital length of stay when used for bronchiolitis, it does not provide immediate relief of distress and should not be administered to children in respiratory distress in the prehospital setting

Pertinent Assessment Findings

  1. Frequent reassessment is necessary to determine if interventions have alleviated signs of respiratory distress or not

Quality Improvement

Associated NEMSIS Protocol(s) (eProtocol.01)

  • 9914221 – Medical-Respiratory Distress-Bronchiolitis
    • Protocol Age Category: 3602005 – Pediatric Only

Key Documentation Elements

Document key aspects of the exam to assess for a change after each intervention:

  • Respiratory rate
  • Oxygen saturation
  • Use of accessory muscles
  • Breath sounds
  • Air entry
  • Mental status
  • Color

Performance Measures

  • CPAP utilization
  • Time to administration of specified interventions in the protocol
  • Rate of administration of accepted therapy (whether or not certain medications/ interventions were given)
  • Change in vital signs (heart rate, blood pressure, temperature, respiratory rate, pulse oximeter, capnography values)
  • Time to administration of specified interventions in the protocol
  • Number of advanced airway attempts
  • Mortality

References

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