Sandbox ammu

Bronchiolitis

Treatment

Note

• Clinicians should administer nasogastric or intravenous fluids for infants with a diagnosis of bronchiolitis who cannot maintain hydration orally
• Clinicians should not administer albuterol (or salbutamol) to infants and children with a diagnosis of bronchiolitis.
• Clinicians should not administer epinephrine to infants and children with a diagnosis of bronchiolitis.
• Clinicians should not administer systemic corticosteroids to infants with a diagnosis of bronchiolitis in any setting.
• Clinicians should not administer antibacterial medications to infants and children with a diagnosis of bronchiolitis unless there is a concomitant bacterial infection, or a strong suspicion of one.
• Nebulized hypertonic saline should not be administered to infants with a diagnosis of bronchiolitis in the emergency department.
• Clinicians should not use chest physiotherapy for infants and children with a diagnosis of bronchiolitis.

Prophylaxis

• Regimen: Palivizumab (15 mg/kg/dose) during the respiratory syncytial virus season to infants who qualify for palivizumab in the first year of life.

Note

• Clinicians should administer palivizumab during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity defined as preterm infants <32 weeks 0 days’ gestation who require >21% oxygen for at least the first 28 days of life.
• Clinicians should not administer palivizumab to otherwise healthy infants with a gestational age of 29 weeks, 0 days or greater.
• All people should disinfect hands before and after direct contact with patients, after contact with inanimate objects in the direct vicinity of the patient, and after removing gloves.
• All people should use alcoholbased rubs for hand decontamination when caring for children with bronchiolitis. When alcoholbased rubs are not available, individuals should wash their hands with soap and water.
• Clinicians should counsel caregivers about exposing the infant or child to environmental tobacco smoke and smoking cessation when assessing a child for bronchiolitis.

Influenza

Treatment

• Preferred Regimen(1): Zanamivir 10 mg (two 5-mg inhalations) BID for 5 days.
• Preferred Regimen(2): Oseltamivir 75 mg BID for 5 days.
• Preferred Regimen(3): Peramivir one 600 mg dose, via intravenous infusion for 15-30 minutes for 1 day.

Prophylaxis

• The chemoprophylaxis dosage of Zanamivir is 10 mg (2 inhalations) once a day.
• The chemoprophylaxis of Oseltamivir is from 3 months and older age group.

• Pediatric dose

Oseltamivir If younger than 1 yr old1: 3 mg/kg/dose twice daily2,3 If 1 yr or older, dose varies by child’s weight: 15 kg or less, the dose is 30 mg twice a day >15 to 23 kg, the dose is 45 mg twice a day>23 to 40 kg, the dose is 60 mg twice a day>40 kg, the dose is 75 mg twice a day.

Zanamivir 10 mg (two 5-mg inhalations) twice daily (FDA approved and recommended for use in children 7 yrs or older).