The 2014 new and updated guidelines for management of bronchiolitis largely focus on tests or treatments to avoid, according to a perspective piece published online April 6 in Pediatrics.
The authors note that 10 of the 14 recommendations in the updated 2014 guidelines focus on tests or treatments to avoid. The emphasis seems to be on avoiding interventions that lack a favorable risk-benefit ratio, focusing on meaningful outcomes such as hospitalization, length of stay, and symptom duration.
Recommendations from the new guidelines include omitting use of bronchodilators and allowing clinicians to omit use of pulse oximetry.
I’ve never been a advocate for bronchodilation for bronchiolitis. Back in the 90’s when my children were babies and toddlers I would never fill a script for SABA’s to treat bronchiolitis. I would opt instead for cool mist aerosol. For the lay folk, I always provide this recommendation. Bronchodilation is prescribed needlessly in adults as well. When will that be addressed? RT’s need to be more involved evaluations and recommendations. Just saying!