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Bronchiolitis — UKMLA MCQ

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HardPaediatricsBronchiolitisUKMLAMRCEM SBAMRCP Part 1

A 10-month-old has coryza followed by cough, tachypnoea, widespread wheeze and fine inspiratory crackles. Oxygen saturation is 93% in air, feeding is reduced but still more than half normal, and there is no apnoea. What is the most appropriate treatment?

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Correct answer: E — Supportive care with hydration safety-netting

The best answer is “Supportive care with hydration safety-netting”. The typical clinical syndrome is bronchiolitis. Most infants without severe hypoxia, apnoea or inadequate intake need supportive care, nasal-clearance and feeding advice with explicit deterioration signs. Bronchodilators, corticosteroids, antibiotics and routine radiography do not improve uncomplicated bronchiolitis. Admission thresholds depend on age, comorbidity, oxygenation, work of breathing and hydration.

Reference: NICE NG9: Bronchiolitis in children: https://www.nice.org.uk/guidance/ng9/chapter/Recommendations