Bronchiolitis
Age: old
Gender:
HISTORY:
Presents with a - history of
Symptoms include:
, of phlegm
,
, up to °, over
Alleviating factors: ,
Contributing factors:
no history of: , , ,
EXAM:
General appearance: ,
Vital signs: , BP , HR , RR , SpO2 %, Temp °
Head: fontanelles ,
Eyes: conjunctiva/sclera , lids/lashes , , extraocular movements , red reflex , corneal light reflex , fix and follow test
Ears: tympanic membranes , auditory canal on , hearing
Nose: , , discharge ,
Throat: , ,
Mouth: mucosa , dentition
Neck: , , , , , c-spine
Heart: , ,
Lungs: , ,
Abdomen: , , ,
Extremities: , , , , Barlow , Ortolani , , cap refill sec
Skin: on
Mental status: , , reactive to
ASSESSMENT:
DDx: viral bronchiolitis, RSV, viral URI, asthma exacerbation, pneumonia, foreign body aspiration, pertussis, influenza, COVID-19, croup, heart failure, cystic fibrosis, primary ciliary dyskinesia, immunodeficiency disorders, GERD
PLAN:
Investigations:
- RSV swab
- Chest X-ray
- Blood work: , , , ,
- Admission to hospital with apnea monitoring if aged less than 3 months
Treatments:
- Nasal saline rinse
- Encourage oral hydration
-
-
-
Further care:
- Follow-up in
- Return if symptoms worsen or if new symptoms develop
- Referral to ER if severe shortness of breath, signs of dehydration, or high fever
HISTORY: EXAM: ASSESSMENT: PLAN: