Essay about Nebuliser Therapies in the Treatment of Bronchiolitis

2026 Words Apr 23rd, 2015 9 Pages
Nebuliser Therapies in the Treatment of Bronchiolitis
Bronchiolitis is a mostly seasonal disease, with the majority of cases being caused by the respiratory syncytial virus. Around 2 -3 percent (30 per 1000) of all children under 1 year old are likely to be admitted to hospital with this disease (Smyth and Openshaw, 2006).
Using a modified version of the Gibbs Reflective cycle (1988) this assignment will evaluate the assessment and treatment of an unwell infant bought in to the children’s ward, and in particular will focus on the efficacy of nebuliser therapies in the treatment of bronchiolitis. Consent was gained prior to questioning and examination and confidentiality maintained throughout (HCPC, 2012).
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Widespread wheezes and crackles were noted on auscultation (Pattemore, 2008). Please see Appendix 1 for the full assessment.
As part of their treatment regime the ambulance crew had administered nebulised salbutamol en route to the hospital, which had had little effect on the baby’s condition. Following a later discussion with a doctor it became evident that salbutamol may not be effective in relieving the symptoms of bronchiolitis, a fact I was unaware of at the time.
Dieckmann et al (2006 pp.66-67) advocate the use of both nebulised salbutamol and epinephrine in severe bronchiolitis as it may “prevent the need for assisted ventilation”. Some studies have felt that salbutamol had benefits over epinephrine, particularly in relation to successfully discharging patients (Walsh, Caldwell and Rothenburg, 2008), although a later paper (DeNicola et al, 2013) found that epinephrine showed greater efficacy in improving clinical signs than salbutamol, a finding also supported by Hartling et al (2011). The question as to whether salbutamol could provide either an immediate or longer term clinical improvement was researched by

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