Category Archives: respiratory problem

chest infection, pneumonia, asthma etc

Croup or LTB: respiratory illness of infant and young children

  • Croup or LTB (Laryngo tracheo bronchitis) is respiratory illness of infants and young children which starts just like any other viral illness but can be life threatening if danger signs are ignored.
  • Croup is a respiratory illness usually caused by a virus. As the illness progresses, windpipe becomes swollen, which narrows the space available for air to enter the lungs.
  • The viruses that cause croup can be spread easily through coughing, sneezing, and respiratory secretions (mucus, droplets from coughing or sneezing).
  • Croup is usually mild, although it is possible for symptoms to become severe and life-threatening. Symptoms usually start gradually, beginning with nasal irritation, congestion, and a runny nose, which may worsen after 12 to 48 hours to include difficulty breathing, a “barking cough”, and hoarseness. Symptoms of croup usually resolve within one week.
  • If, at any time, a child develops features of worsening or severe croup, the parent should seek immediate medical attention. Danger signs include:
  1. Difficulty breathing
  2. Pale or blue-tinged skin, especially in the lips, fingers, toes, or earlobes
  3. Severe coughing spells
  4. Drooling or difficulty swallowing
  5. Inability to speak or cry due to difficulty taking a breath
  6. A whistling sound with breathing or noisy-high pitched breathing while sitting or resting(stridor)
  7. Sucking in of skin around the ribs with breathing (retractions)
  • Mild croup can usually be treated at home. Home treatment includes using mist from a humidifier or by sitting with the child in a bathroom filled with steam generated by running hot water from the shower. Hot steam humidifiers should be avoided because of the risk of burns.
  • Severe croup is a life-threatening illness and treatment should not be delayed for any reason and opinion of child specialist doctor should be taken immediately (as oxygen and need to secure the airway is needed).
  • Clinical Diagnosis: No investigation is needed.
  • TREATMENT:
    • Child may be given mist treatment (humidified air) in addition to a single dose of a glucocorticoid medication. The most frequently used glucocorticoid is dexamethasone.
    • Coughing can be treated with warm, clear fluids to loosen mucus on the vocal chords. Warm water, apple juice, or lemonade is safe for children older than six months.
    • Smoking in the home should be avoided; smoke can worsen a child’s cough.
    • Keep the child’s head elevated. A child may be propped up in bed with an extra pillow. Pillows should not be used with infants younger than 12 months of age.
    • Other therapies, such as antibiotics, cough medicines, decongestants, and sedatives, are not recommended for children with croup. Antibiotics do not treat viruses, which cause most cases of croup.
    • Parents should not leave child unattended for long time especially during night so that they will be immediately available if the child begins to have difficulty breathing.

Unfortunately, there is no way to prevent croup. There are no vaccines against most of the viruses that can cause croup.

Simple hygiene measures can help to prevent infection with the viruses that can lead to croup. These measures include:

  • Frequent hand washing with soap and water.
  • Use of alcohol-based hand rubs.
  • Avoid close contact with other adults and children with upper respiratory infection when possible. This may be difficult, especially when in public, but parents can try to limit direct contact. In addition, infants or children who are sick should not be sent to day care or school as this can potentially cause others to become ill.
  • Yearly vaccination for the influenza virus is recommended for individuals older than six months, who are having repeated respiratory illnesses.

Whenever in doubt its always better to consult your child specialist/ Pediatrician.

stay healthy

Regards

Dr Rahul Varma

Are you worried about use of Nebulizer for your child? Read on

Nebulizers: Myths and Facts

In my Clinical practice I have seen so many parents and relatives of young children saying “NO to Nebulization”. Many parents do not want to nebulizer their kids as they think it causes addiction and is meant only for severe asthmatic patient.

Any person who is new to nebulization may have some misconceptions (especially lots of myth in public). The aim of this blog is to clear them.

 nebulizer_mask

What is Nebulizer?

It is a device which delivers liquid medicine in form of a mist inhaled in to the lungs. It is battery/electricity operated. Patients breathe through mouthpiece or face mask. They come in different shapes and sizes and create sound (as driven by a motor).

 nebulizer (mayaclinic.in)

 

Myth #1: It will cause addiction and will have to be used every time.

Fact: Nebulization is a mode of delivering a medicine. It does not cause addiction. Addiction is a attribute of drug (or medicine); it does not depend on mode of delivery. If any medicine has addiction potential, it will be for every mode of delivery i.e. oral, intravenous, intramuscular etc.

 

Myth#2: It is very strong i.e very high dose of medicines given through it.

Facts: Doses of medicine is very less as compared to oral medicine.  As drug goes directly where it is intended lower dose is needed. (Up to 100 to 1000 times less dose is needed in nebulizer as compared to oral or intravenous medicine).

 

Myth#3: It has more side effects

Facts:  Side effects are far less with nebulizers. As the drug is delivered directly into the lungs where it has to act; hence side effects are less. Whereas oral medications in form of syrups and dispersal tablets first goes into stomach where they are absorbed and then distributed in body so side effects are more.

 Nebulizer-Time

Myth#4: It takes longer time for drug to start acting.

Facts: Wrong.  As the medicine is going in form of mist directly into the lungs, so it will act faster and give relief much more quickly than oral medication.

 

Myth#5: It is very expensive.

Facts: No, the cost of each vial of medicine is very low as compared to oral medicines. And in case condition of child worsens than cost of one day of hospitalization will be much more than entire course of nebulization.

Myth#6: It is used ONLY for ASTHMA patients.

Facts: Nebulization is used in many conditions in children eg. Bronchiolitis, Wheeze associated lower respiratory tract infection (WLARI), RSV infection, emphysema. Most commonly it helps via dilating respiratory passage (bronchodilation) or decreasing edema (in case epinephrine is used). For children it is difficult to spit out sputum, so use of nebulization might help.

 

Myth#7: It is very complicated.

Facts: It is very simple and easiest way. You just have to connect the tubing with mask and fill the medicine and turn on the device. Child can breathe normally; no need to take deep breathing. Even your child can do it on its own and may feel like it’s a playful activity rather than and forceful thing (giving oral medicines). Inhalers are more complicated for children.

 

Myth#8: Proper dose is not delivered via nebulizer as most of it will go in air.

Fact: Nebulizers are considered as the best way to deliver the medicines in children (in case of hyper reacting airway illness). With inhalers you need to coordinate breathing with medicine dispersal. Oral medications can have erratic absorption as it depends on condition of gut (stomach upset can lead to poor absorption of medicines).

 nebulizer kids(mayaclinic.in)

Myth#9: You have to carry your nebulizer with you.

Fact: Now, so many portable ones are there, so it is very easy to carry them.

 nebulizers 3 clinic

Myth#10:  My baby is very small, it may harm the baby.

Facts: No. Smaller the baby more difficult it s for them to take out their flem. Nebulization will help them to take out all the secretions as it  will dilate the  respiratory passage. Nebulization will not harm your baby.

And lastly have faith in your doctor; they will not advise anything that is not good for baby. Remember both parents and doctors want your baby to get well soon.

 

 nebulizaion (mayaclinic.in)

 

Feel free to contact your child specialist or contact us at MAYA CLINIC.

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”

FLu Vs Cold: Know the difference

 flu vs cold

Question: Your child develops fever, cough along with sore throat; could it be just a Simple viral infection like common cold? Or is it Flu?

Answer:  It is not easy to differentiate between two of them. Symptoms are more or less the same, although Flu like symptoms can be severe.

Differentiating features on the basis of Symptoms are:

Questions to ask Cold Flu
Onset of illness Slow Sudden
Intensity of fever No fever or mild fever High fever
Weakness/ fatigue/exhaustion Mild Severe
Appetite (oral intake) Normal/ slightly decreased Significantly decreased
Body ache/Headache/muscular Pain No Yes
Chills (Shivering) No chills Yes
Difficulty in breathing No Yes, in severe cases
Decreased Urine output No Yes, in severe cases

 

This is just a rough guide; a thorough check up a child specialist will help in reaching a diagnosis.

flu season

Symptoms can change as the disease progresses. So it is important to know the general danger signs which if present should be reported to your child doctor immediately. These are:

  • Poor oral intake
  • Baby did not pass urine for last 8- 10 hours.
  • Loss of consciousness/ Drowsy/ sleepy most of the time
  • Difficulty in breathing/ Retractions in chest wall during breathing
  • Severe and persistent headache

Other possible causes of illness should also be ruled out like bacterial infections, Pneumonia etc.

While even healthy kids can have complications of the flu, kids with certain medical conditions are at more of a risk. If you think your kid might have the flu, contact your doctor.

flu-season

Management

Most of the cases of Flu can be managed at home by offering plenty of fluid to child along with adequate rest and avoiding crowded places.

Some children might develop serious illnesses for which child might need hospitalization and antiviral medications like tamiflu to ease flu like symptoms (but for best results it should be started within 48 hours of development of symptoms; which is practically difficult).

flu shot

Vaccination (Annual Flu shot) can be given to all the people every year to prevent spread of serious illness.

 

Regards

Dr Rahul Varma

How to manage Cough in children ?

5

Most common symptom and in all probabilities every child has had it once.  Important fact which I would like to share is that COUGH is a Protective reflex. It protects the spread of infection to airways in lung. But on certain occasions it needs a doctor’s visit; especially if the child is having breathing difficulty and not able to sleep at all at night.

Different types of Cough:

 

Cough with barking sound:

Swelling in upper airway leads to barking cough i.e. swelling of Voice box (Larynx) or Windpipe (trachea) or whole of upper part in LTB (Croup). Croup is due to viral infection in most cases. It is sudden in onset and severe in younger kids with narrow airway. It has harsh, noisy character which occurs when child inhales.

Cough with whistling (or musical sound):

When lower airway is involved it leads to musical or whistling sound. It can be sometimes audible from a distance too. Common causes are viral infections like Bronchiolitis in young children, WALRI & Asthma. Foreign body is also important cause in kids.

 

Cough with Fever:

Cough associated with mild fever & running nose is mostly due to common cold. But if cough is associated with high grade fever and no running nose and breathing difficulty than Pneumonia needs to be ruled out. You should visit your child specialist soon.

 

Cough with vomiting:

Post tussive vomiting is very common in young children and should not be a cause a worry. As babies are not able to throw up mucus and secretions from lungs naturally by taking deep breath voluntarily, so vomiting with cough might relieve the child for some times . It occurs as cough can sometimes trigger gag reflex.

Persistent Cough:

Viral infections can last for 2 weeks. Children with asthma, allergies or chronic infections or repeated viral infections can cause persistent cough but if cough persists for more than 3 weeks than doctor visit is needed.

Prevent triggers: Cold Air, perfumes, Smoke, ice creams etc can start or prolong the cough in children.

When is the right time to visit Child Specialist?

If your child is having any of the below features, you should contact your pediatrician

  • Fast breathing
  • Deep and effortful breathing
  • Bluish color on lips, face
  • High grade fever and no running nose
  • Young child less than 3 months old especially with fever
  • Special sound with cough. Eg Whopping cough, Stridor (noisy), musical sounds/ wheezing etc
  • Blood with cough
  • Child is very weak, irritable and cranky
  • Poor oral intake, decrease urine output and looks dehydrated.

 

Expected treatment from Doctor?

Listening to the sound of cough can help doctor, besides History and clinical examinations.

Doctor should try to find the cause of cough and treat that. If it is viral infection, it will have its own course and will settle down with time only (usually around 2 weeks in children). No need of any cough syrup (medicine), unless the cough is disturbing sleep or child is coughing continuously for few minutes at a stretch and his life is disturbed significantly.

If cough medications are to be used than it is better to avoid combination drugs.

 

Home remedies:

  • Honey at bed time can have soothing effect and prevent cough.
  • Warm milk with Haldi
  • Warm saline gargles
  • Steam inhalation can be given in certain cases. But in small kids , need to be very careful that they do not get burn injury with hot water. Best way is to generate steam via hot water in closed room or bathroom. And sit with your child in that room and let the child breath normally.
  • Cool-mist humidifier in your child’s bedroom might help with sleep.
  • Keep child well hydrate
  • Avoid over the counter medications and give them only on prescription of a child specialist.

 

Feel free to contact MAYA CLINIC for any queries.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”

Cough in Children: What to do ?

 

 1

Cough is the most common symptom and in all probabilities every child has had it once.  Important fact which I would like to share is that COUGH is a Protective reflex. It protects the spread of infection to airways in lung. But on certain occasions it needs a doctor’s visit; especially if the child is having breathing difficulty and not able to sleep at all at night.

Different types of Cough:

5

Cough with barking sound:

Swelling in upper airway leads to barking cough i.e. swelling of Voice box (Larynx) or Windpipe (trachea) or whole of upper part in LTB (Croup). Croup is due to viral infection in most cases. It is sudden in onset and severe in younger kids with narrow airway. It has harsh, noisy character which occurs when child inhales.

download

Cough with whistling (or musical sound):

When lower airway is involved it leads to musical or whistling sound. It can be sometimes audible from a distance too. Common causes are viral infections like Bronchiolitis in young children, WALRI & Asthma. Foreign body is also important cause in kids.

4

Cough with Fever:

Cough associated with mild fever & running nose is mostly due to common cold. But if cough is associated with high grade fever and no running nose and breathing difficulty than Pneumonia needs to be ruled out. You should visit your child specialist soon.

 

Cough with vomiting:

Post tussive vomiting is very common in young children and should not be a cause a worry. As babies are not able to throw up mucus and secretions from lungs naturally by taking deep breath voluntarily, so vomiting with cough might relieve the child for some times . It occurs as cough can sometimes trigger gag reflex.

Persistent Cough:

Viral infections can last for 2 weeks. Children with asthma, allergies or chronic infections or repeated viral infections can cause persistent cough but if cough persists for more than 3 weeks than doctor visit is needed.

Prevent triggers: Cold Air, perfumes, Smoke, ice creams etc can start or prolong the cough in children.

3

When is the right time to visit Child Specialist?

If your child is having any of the below features, you should contact your pediatrician

  • Fast breathing
  • Deep and effortful breathing
  • Bluish color on lips, face
  • High grade fever and no running nose
  • Young child less than 3 months old especially with fever
  • Special sound with cough. Eg Whopping cough, Stridor (noisy), musical sounds/ wheezing etc
  • Blood with cough
  • Child is very weak, irritable and cranky
  • Poor oral intake, decrease urine output and looks dehydrated.

 2 

Expected treatment from Doctor?

Listening to the sound of cough can help doctor, besides History and clinical examinations.

Doctor should try to find the cause of cough and treat that. If it is viral infection, it will have its own course and will settle down with time only (usually around 2 weeks in children). No need of any cough syrup (medicine), unless the cough is disturbing sleep or child is coughing continuously for few minutes at a stretch and his life is disturbed significantly.

If cough medications are to be used than it is better to avoid combination drugs.

 cough-remedy-poster

Home remedies:

  • Honey at bed time can have soothing effect and prevent cough.
  • Warm milk with Haldi
  • Warm saline gargles
  • Steam inhalation can be given in certain cases. But in small kids , need to be very careful that they do not get burn injury with hot water. Best way is to generate steam via hot water in closed room or bathroom. And sit with your child in that room and let the child breath normally.
  • Cool-mist humidifier in your child’s bedroom might help with sleep.
  • Keep child well hydrate
  • Avoid over the counter medications and give them only on prescription of a child specialist.

 

Feel free to contact MAYA CLINiC for any queries.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”

 

Overweight and childhood Obesity

food         Obesity-Cycle  

Childhood Obesity is a major health problem these days. Initially it was supposed to be disease of western countries and affluent class, but data clearly shows that it is very rampant in middle class families. Main reason as we all know are changing lifestyle with lots of junk food and minimal physical activity. It is important to be in touch with your pediatrician.

Definition: Simplistically, Obesity results from an imbalance of caloric intake and energy expenditure.

BMI (Body Mass index): BMI charts are available which can be used in children > 2years old,

BMI= Weight (in kg)/ Height (in meter)2

Obesity:  BMI more than or equal to 95th percentile

Overweight:  BMI between 85th and 95th percentile

Factors leading to obesity:

child-obesity

  • Enviornmental factors:
    • calorie dense food
    • consumption of processed foods
    • limited physical activity
    • sedentary interests: computers, TV, video games

 

  • Genetics factors also play important role in some cases

Co-Morbidities associated with childhood obesity:

  • Cardiovascular: Dyslipidemia, Hypertension
  • Endocrine: Type 2 Diabetes Mellitus, Metabolic syndrome, polycystic ovary Syndrome
  • Gastrointestinal: Gall bladder disease, Non Alcoholic fatty liver disease
  • Psychosocial effects and stigma
  • Orthopedic complications:  joint pain etc.
  • Respiratory: Sleep Apnea
  • Neurologic:  Pseudotumor cerebri

 

Interventions:

Successful intervention for obesity is challenging and is best accomplished using multimodal approaches to accomplish lifestyle change. In children we do not want rapid weight loss as child is in growing phase and adequate nutritious diet is needed. So it is best to try to retain the same weight or very slow weight loss.

  • Catch them young – school age children must be targeted
  • Do not skip meals especially Breakfast
  • Increase awareness: media; school teachers; governmental and NGO effort
  • Minimise advertising pressure for  “junk foods”
  • School play grounds; “Games periods”
  • Health food in school canteens

Traffic light Diet Plan:

Features Green light food Yellow light food Red light food
Quality Low -calorie, high –fiber, low-fat, nutrient-dense Nutrient-dense, but higher in calories and fat High in calories, sugar and fat
Types of food Fruits, vegetables Lean meats, dairy, starches, grains Latty meats, sugar, fried foods
Quantity Unlimited Limited Infrequent or avoided

  

Conclusion:

  • India is in the midst of an escalating epidemic of life style disorders associated with childhood

obesity.

• The important causes of the epidemic in India appear to be:  unhealthy eating pattern, reduced

physical activity, increased sedentary pursuits .

• Prevention must begin early in the form of a public health campaign directed towards lifestyle

changes of the family / society as a whole. The campaign requires strong social and political will.

• Health professionals must think `prevention of obesity’ at all visits, monitor BMI and ensure that

‘nutrition messages’ are not conflicting and confusing.

• Special strategies for different ages and channels of interventions for prevention of obesity have

been outlined.

• Clinic based individual assessment of the obese child and principles of therapy are provided.

 

For any queries consult your child doctor or feel free to contact Maya Clinic. we will be more than happy to answer all of them.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”

 

Asthma in children

child-asthma     ASTHMA_kid

In this disease airways are hyperreactive, which means that there is narrowing of airways which leads to difficulty in breathing.

By definition, Asthma is a chronic inflammatory disorder of the airways, characterized by recurrent, reversible, airway obstruction. Airway inflammation leads to airway hyperreactivity, which causes the airways to narrow in response to various stimuli, including allergens, exercise, and cold air.

Most common symptoms of Asthma is Wheezing but all asthmatic children do not wheeze. Most common symptoms of recurrent airflow obstructions are

  • Recurrent wheeze (wheeze is heard by stethoscope but sometimes audible whistling sounds )
  • Recurrent isolated cough
  • Recurrent breathlessness
  • Nocturnal cough
  • Tightness of chest

Signs are (examination by doctor):

  • Generalized rhonchi (wheezing sounds heard with a stethoscope)
  • Prolonged expiration
  • Chest hyperinflation (on X ray of Chest)

 

The Ten Commandments of Asthma

 

  • Asthma is a chronic condition with episodic symptoms. There is a need for continuous preventer drugs for certain grades of asthma. The drugs used for asthma ‘control’ asthma but do not ‘cure’ asthma.
  • A majority of children outgrow their symptoms as they grow older.
  • There are lots of myths and misconceptions regarding inhaled therapy which need to be cleared. Medications given using inhaled route have their own merits and advantages.
  • Discuss the selected regime and address concerns regarding usage of medications with your doctor.
  • Discuss the usage and maintenance of the inhaler device selected.Carry the inhaler device at each follow up visit.
  • It may take some time taken to note improvement and need for compliance with the prescribed preventer drugs cannot be over-emphasized.
  • Dealing with triggers / precipitants like dust, pollen, fur, smoke, exercise etc can go a long way in controlling the symptoms, and preventing asthmatic attacks. Diet has a small role in causation of symptoms.
  • Maintain a diary of events and carry it at each follow up visit. Record days that there are events such as daytime cough, nocturnal cough, wheeze, reliever medication use, doctor/hospital visits, school absenteeism due to symptoms etc.
  • Learn how to manage acute exacerbations/ sudden asthmatic attacks at home prior to doctor contact.
  • Go for the follow up visit 2-4 weeks after institution of preventer regime. Subsequent visits may be planned 2-8 weekly according to the severity or earlier in case of recurrences, or as your specialist plans.

The eleventh commandment (During follow up)

  • Identify any lacunae in understanding and clarify all doubts in subsequent meetings.

********************************************************

Advantages of the inhaled route (MDI pump and nebulizers) are

  • ‘Smaller dose’: Contrast the milligram (mg) concentration of syrups and tablets with the microgram (mcg) concentration of the same drug in the inhaled form.
  • ‘Target delivery’ – ‘Quicker action’: Drug is delivered directly to the site of action. Reliever drugs, therefore, act faster.
  • ‘Safer’: Smaller dose and thus, much better safety profile than with oral therapy. This is particularly relevant for steroids.

Misconceptions which need to be cleared

  • Is inhaled therapy addictive?  I want to emphasize that addiction liability is a property of the drug rather than device / route. Example that alcohol, though oral, is still addictive. None of the asthma medications are known to cause dependence.
  • Is inhaled therapy strong? No, as discussed earlier, smaller dose is needed (microgram concentration) of drugs used.
  • Is inhaled therapy expensive? The inhaler device is a one-time purchase. Only drugs need to be purchased subsequently. A few inhaled drugs may be slightly more expensive than oral drugs on a per dose basis but these in the context of the child’s well being, safety and reduced doctor / hospital visits are better option.
  • Are inhalers easy enough for children to use? MDI pumps used with spacer can be given to small children also with ease and technique is very easy.

Typical features of this disease

  • Afebrile episodes (most cases)
  • Personal atopy or skin allergy
  • Atopy / Asthma in a parent or sibling
  • Exercise / Activity: In a smaller child, laughing or crying may provoke symptoms.
  • Triggers: These are usually inhaled irritants or aeroallergens (page 10).
  • Seasonality: Sudden temperature changes, flowering season and harvesting time are risk situations. This feature can be judged only after observation over a sufficient time period.
  • Later onset of symptoms (usually around 3 years of age)
  • Relief with bronchodilator (asthalin )± short-course oral steroid

In children, asthma is a clinical diagnosis, made by evaluation over time, either retrospectively or prospectively.

Investigations help in confirming or ruling out alternative diagnoses, rather than in diagnosing asthma.

Asthma Poster

Classification of asthma, Treatment protocol and whether asthma is well controlled or poorly controlled can be read in detail by reading the below mentioned link.

As per management of asthma, there are plenty of medicines which can be given by different routes . So discuss in detail with your Child Specialist / Pediatrician regarding what is best for your child.

Most of the children outgrow this disease with proper treatment and live symptom free life. There are plenty of sports persons who had asthma and they still compete at international level.

Our positive mind set along with caring attitude and emotional support for children can give them symptom free childhood.

If you are interested in reading in detail regarding this disease (that to especially in Indian scenario), than read the guidelines of Indian Academy of Pediatrics. Below is the link for that.

 

For any queries feel free to contact at Maya Clinic or discuss with your child specialist.

“Healthy kids, Happy family”

Regards

Dr Rahul Varma

 

BRONCHIOLITIS (common lower respiratory illness of young children)

Small children are very prone to viral infections involving the respiratory tract; most of them are Viral URI (upper respiratory tract infections). These URI usually have running nose along with fever and cough.

Whereas in Bronchiolitis, cough and fast breathing is major concern.Timely visit to child specialist/ Pediatrician is best for early detection and prevention of serious illness.

Bronchiolitis_anatomy_PI

Bronchiolitis: most common lower respiratory (airway) illness in Infants

Cause: viral illness (RSV virus most common, parainfluenza virus, influenza virus, adenovirus).

Symptoms usually get worse during the first three days and then gradually improve. During this time, your child may experience:

  • Cough and fast breathing (with audible wheezing or whistling sound sometimes).
  •  Fever.
  • Noisy breathing
  • Irritability
  • Poor  feeding

Total duration of illness is around 1 week (with waxing and waning course).

Following are the danger signs

  • increased difficulty breathing or wheezing as they breathe
  • poor feeding
  • no wet nappy for 12 hours or more
  • a rapid breathing rate of > 50 breaths per minute in 2months to 12 months child
  • being very tired or lethargic

Bronchiolitits

Diagnosis: Clinical diagnosis, no investigations needed if diagnosis is clear from history and physical examinations done by a child specialist / Pediatrician.

Treatment:

Supportive:

  • Keep your child upright (symptoms worsen on lying down)
  • Drink plenty of fluids
  • steam inhalation or saline nebulization
  • Smoke free environment
  • paracetamol drops for fever
  • Saline nasal drops

Specific:

  • Nebulization with Adrenaline
  • Trial with salbutamol can be given, if response there then continue or else give adrenaline nebulization only.

Following drugs have no role in treatment of this disease:

  • Antibiotics
  • Steroids
  • Antiviral drugs like rabavirin etc

As this infection is viral illness, so it cannot be prevented but keeping good personal hygiene will decrease the chances of catching this illness in children.

Stay healthy

Regards

Dr Rahul