1. Q13: Bronchiolitis Simon Craig

2. 3 parts Table – clinical severity List of risk factors for severe complications Indications for a chest x-ray

5. Clinical severity assessment 12 marks 6 marks for the various clinical factors 6 marks for sensible delineation of mild / moderate / severe

6. Clinical severity assessment Clinical factors Behaviour Respiratory rate Accessory muscle use Feeding Oxygen Apnoeic episodes NOT Speech Wheeze Crepitations Cough Stridor

7. Risk factors for severe disease 6 marks Young (<6 weeks) Ex-premature infants Congenital heart disease Neurologic conditions Chronic respiratory illness Pulmonary hypertension Indigenous Delayed presentation Failure to thrive / LBW NOT Immunisation status Diabetes Smokers at home <6 months Sepsis Dehydration Pneumothorax Sats <92% despite oxygen

8. Chest x-ray 2 marks Severe illness, eg CPAP or intubation Localised signs on auscultation Murmer with signs of congestive cardiac failure NOT Fever Low saturations Septic, eg temp >40 SBP <80 ?inhaled foreign body

9. Pass mark? 12 / 20

11. Questions? ?