Management and Prevention Strategies for Respiratory Syncytial Virus (RSV) Bronchiolitis in Infants and Young Children: A Review of Evidence-Based Practice Interventions

Allison C. Cooper; Nancy Cantey Banasiak; Patricia Jackson Allen

Disclosures

Pediatr Nurs. 2003;29(6) 

In This Article

Diagnosis

The diagnosis of bronchiolitis is made by history and physical examination. Diagnostic criteria include exposure to persons with URI symptoms, a prodromal phase of URI symptoms followed by wheezing occurring during the winter months (AHRQ, 2003; Children's Hospital Medical Center [CHMC], 2001). Differential diagnoses include asthma, pneumonia, cystic fibrosis, heart failure, foreign body aspiration, pertussis, and tumor (Orenstein, 2000). In infants and children with moderate or severe respiratory symptoms, a chest x-ray is often ordered to rule out other respiratory conditions. Radiographic examination findings of bronchiolitis reveal hyperinflation, patchy atelectasis, and peribronchial wall thickening and can usually differentiate between pneumonia and bronchiolitis. Definitive diagnosis of RSV as the causative agent for bronchiolitis is accomplished by enzyme-linked immunosorbent assay (ELISA) that detects antigens. A nasal washing specimen is obtained and has a sensitivity ranging from 80%-90% (AHRQ, 2003). However, according to the AHRQ (2003), routine laboratory screenings such as RSV assays, complete blood counts (CBCs), and chest x-rays provide little additional information above and beyond a thorough history and physical examination in the diagnosis of RSV bronchiolitis.

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