Summary of guideline
Clinical Contents:
- Diagnosis
- Initial illness severity assessment
- Risk factors for severe illness
- Investigations
- SARS-CoV-2 co-infection
- Monitoring
- Respiratory support
- Medication
- Nasal suction and clearance techniques
- Hydration and nutrition
- Discharge planning
- Prevention of RSV bronchiolitis
- Infection control
- Education modules
Technical Contents:
Nasal suction and clearance techniques
Nasal suction
Do not routinely use nasal suction in the management of infants with bronchiolitis. (Evidence quality: low; recommendation strength: conditional)
However, superficial suctioning may be considered in infants with respiratory distress or feeding difficulties from upper airway secretions. (Evidence quality: low; recommendation strength: conditional). Superficial suctioning refers to suctioning of the nose.
Additionally, one off suctioning may be performed prior to oxygen supplementation to increase patient comfort and avoid clogging of nasal prongs.
Do not routinely use deep nasal suctioning for the management of infants with bronchiolitis. (Evidence quality: low; recommendation strength: weak). Deep suctioning refers to any suctioning beyond the nose, such as the nasopharynx.
Nasal saline
Do not routinely use nasal saline drops in the management of infants with bronchiolitis. (Evidence quality: very low; recommendation strength: conditional)
A trial of intermittent nasal saline drops could be considered at the time of feeding in infants with reduced feeding. (Evidence quality: very low; recommendation strength: conditional)
Chest physiotherapy
Do not routinely use chest physiotherapy in infants with bronchiolitis. (Evidence quality: low; recommendation strength: conditional)