A clinical pathway for bronchiolitis is effective in ：毛细支气管炎临床路径是有效的.ppt

* Discharge criteria: Tolerating feeds. Parents can handle well to baby at home and can identify ,if baby,s condition deteriorates. ? family education complete Respiratory Status : ? respirations less than 70 per minute and/or no clinical evidence of increased work of breathing or distress ? parent can clear the infant’s airway using bulb suctioning ? patient’s oxygen saturation remains 92 % on room air * Follow Up : follow-up appointments to check for, Any complications like, otitis media, effusion or asthma. * Hand washing is strongly recommended : PREVENTION: preferably with alcohol-based rubs , antimicrobial soaps before and after contact with patient or with objects in patient’s vicinity after removing gloves void contact with viral infections. Educate personnel and family members on hand hygiene * Attempts to provide immunity to RSV: Passive immunity via hyper immune globulin. Monoclonal antibody to F protein (palivizumab) 55% ? hospitalizations for preterm/chronic lung disease 45% ? hospitalizations for congenital heart disease Palvizumab injection, is given on monthly basis during rsv season. RSV immunoprophylaxis(passive immunization) RSV IVIG?/monoclonal antibody : Palivizumab (Synagis?) * *Receiving medical therapy for CLD within 6 months Guidelines for RSV Prophylaxis: Premature, no CLD, no CHD 29-32 wks GA Palivizumab if ≤6 months at start of RSV season ≤28 wks GA Palivizumab if ≤12 months at start of RSV season 32-35 wks GA Palivizumab if ≤6 months at start of RSV season with two risk factors present Chronic Lung Disease* (CLD) Hemodynamically Significant CHD Palivizumab if ≤2 years old at start of RSV season * American Academy of Pediatrics (AAP) Guidelines for palvizumab: Infants born at 32 weeks of gestation or earlier may benefit from RSV prophylaxis, even if they do not have CLD. For these infants, major risk factors t