In response to Episode 59 with Dr. Sanjay Mehta and Dr. Dennis Scolnik on the emergency department diagnosis and management of Bronchiolitis, Dr. Amy Plint , one of Canada’s most prominent researchers in Bronchiolitis and the Chair of Pediatric Emergency Research Canada, tells her practical approach to choosing medications in the emergency department, the take home message from her landmark 2009 NEJM study on the use of nebulized epinephrine and dexamethasone for treating Bronchiolitis, and the future of Bronchiolitis research.

Key Bronchiolitis Resources

For the full length Episode on the the diagnosis and management of Bronchiolitis go here.

For the Written Summary of Episode 59 on Bronchiolitis go here.

Amy Plint Landmark NEJM Bronchiolitis RCT ‘Epinephrine and dexamethasone in children with bronchiolitis‘

Canadian Pediatric Society 2014 Bronchiolitis Guidelines

American Academy of Pediatrics 2014 Bronchiolitis Guidelines

Update 2017: A recent RCT from France by Milési et al. suggests Nasal CPAP is superior to High Flow Nasal Cannula (HFNC) for non-invasive respiratory support in infants with moderate to severe acute viral bronchiolitis. It demonstrated improvement in regards to a validated bronchiolitis severity score, respiratory rate, validated infant discomfort score, and apneic episodes. Abstract

Update 2018: A multicentre randomized controlled trial involving 1472 infants <12 months old with bronchiolitis and treated outside an ICU, demonstrated significantly lower rates of escalated care due to treatment failure using high flow nasal oxygen compared to standard therapy (NNT=9). Abstract

For more Pediatric EM learning visit one of EM Cases newest collaborators trekk.ca – Translating Emergency Knowledge for Kids (TREKK) is a growing network of researchers, clinicians, health consumers and national organizations who want to accelerate the speed at which the latest knowledge in children’s emergency care is put into practice in general EDs – rural, remote or urban.

For more on Bronchiolitis on EM Cases:

Episode 59: Bronchiolitis

BCE 66 CHD with Bronchiolitis: A Delicate Balance

Dr. Helman and Dr. Plint of no conflict of interest to declare