Bronchiolitis is the inflammation of the small bronchi (the bronchiolus) caused by a viral infection.

This is a severe respiratory illness in infants and young children under two years of age.

a. History. Be sure to take a good history. Ask the following questions:

(1) Is there a family history of asthma or allergies?

(2) Does the child have known allergies? If the answer is yes, he could have asthma.

(3) Has the child had a low-grade fever recently? If the answer is yes, he may have bronchiolitis.

b. Signs/Symptoms. Included are the following:

(1) Look for signs of infection such as low-grade fever.

(2) Look for signs of respiratory distress such as wheezing, coughing, and sputum production.

(3) The child’s age is important. If he is under one year and has the signs and symptoms of bronchiolitis, he is likely to have bronchiolitis.

c. Treatment. Treat as follows:

(1) Administer humidified oxygen by mask.

(2) Place the child in a semi-sitting position with his neck slightly hyperextended.

(3) Give epinephrine 1:1000 subcutaneously (SQ) if ordered by a physician.

(4) Prepare a laryngoscope and endotracheal tube of the appropriate size.

(5) Monitor the child’s cardiac rhythm.