Viral induced wheeze

VIW is more similar to Asthma in children than Viral bronchiolitis

which wheeze is it?

Bronchiolitis VIW
coryzal prodrome → cough variable length coryzal illness → faster onset of wheeze
typically <1 year of age 1-5 years old

wheezy kids

bronchodilators

  • salbutamol via MDI >> nebuliser
    • MDI less likely to cause tachycardia
  • If not responding to initial treatment, then early ipratropium nebulisers and oral steroids should be given
  • If IV treatment is needed, magnesium sulphate IV is first-line, not aminophylline or IV salbutamol.

steroids?

VIW or asthma? not sure?

  • give steroids if severe, or mod/severe wheeze without prev diagnosis of asthma

cxr?

  • not routine.

discharge advice

  • sats >94%, managing with 4h bronchodilators
  • check inhaler technique
  • optimise existing treatment if any
  • GP f/up soon (in the next few days)
  • many children with VIW do not subsequently develop asthma

#respiratory #paeds

https://dontforgetthebubbles.com/steroids-in-preschool-wheeze/
https://www.rcemlearning.co.uk/foamed/w-is-for-winter-and-wheeze-paediatric-acute-asthma/
https://gppaedstips.blogspot.com/2016/10/why-bronchiolitis-doesnt-get-better.html
https://www.rcemlearning.co.uk/foamed/coughing-wheezy-and-stridulous-children/