Bronchiolitis: Respiratory Syncytial Virus (RSV) (Pediatric Nursing)

00:01 Now let's talk about the respiratory disorders, bronchiolitis and RSV.

00:06 Bronchiolitis is a lower respiratory tract infection.

00:10 The virus causes inflammation of the small airways, the bronchioles.

00:15 Bronchiolitis occurs in children <2 years old.

00:18 The inflammation partially or completely blocks the airways, sometimes, resulting in wheezing.

00:24 Due to the inflammation and mucus produced by this disease, less oxygen is available to be exchanged, potentially causing hypoxia, or decreased oxygen available to reach the tissues.

00:36 Bronchiolitis is the leading cause of hospitalization in infants and young children.

00:42 So it's very important that the clinician understands the disease process, the signs and symptoms, and the management of this disorder.

00:50 Viruses are the most common cause of bronchiolitis.

00:53 And the most common virus that causes bronchiolitis is respiratory syncytial virus, or RSV.

01:00 It's a very common virus that affects just about every child by the age of 2.

01:05 While the clinician does not always test for RSV when diagnosing a child with bronchiolitis, the terms are often interchangeable since it is the most common cause.

01:15 Bronchiolitis can also be caused by other viruses, including influenza, adenovirus, and parainfluenza strains.

01:23 Unfortunately, infants can be re-infected with RSV because at least 2 strains of the virus exist.

01:30 Fortunately, though, the subsequent infections are usually milder.

01:35 Bacterial infections cause bronchiolitis less frequently.

01:39 Culprits include <i>Mycoplasma pneumoniae</i>, <i>Strep pneumonia</i>, and <i>Haemophilus influenza</i>.

01:46 While the viruses and bacteria that cause bronchiolitis do not discriminate and they can infect children of all ages and states of health, some children have risk factors that increase their likelihood of experiencing bronchiolitis.

01:58 These include prematurity, because the lungs may be underdeveloped, and this increases the likelihood of respiratory illnesses and complications.

02:07 Children who are exposed to second-hand smoke and children who attend daycare as this increases their exposure to other kids who may also have RSV or bronchiolitis.

02:18 Children with an older sibling, for the same reasons.

02:21 Children with a lung or heart defects.

02:24 Children who are immunocompromised, and children who are not breastfed as they're not receiving these protective antibodies.

02:31 Hand hygiene can help decrease the transmission of the viral droplets, especially, prior to touching your eyes, nose, and mouth, which are the entry points for the virus.

02:42 Remember, bronchiolitis results in inflammation of the bronchioles, which are the smallest airways in the lungs.

02:48 The infection makes the bronchioles swell and become inflamed.

02:52 To further complicate the matters, mucus develops and then collects in these small tiny airways, making it difficult for the transportation and exchange of air into and out of the lungs.

03:03 On the top, you'll see normal, clear, and open bronchiole tube.

03:07 Below, you'll see a bronchiole tube in the setting of bronchiolitis.

03:11 The center of the airway is thickened, decreasing the diameter available for the airflow, and the presence of mucus is going to further complicate the situation.

03:21 The viruses and bacteria that cause bronchiolitis are very easily spread.

03:26 Droplets are spread when someone who's infected sneezes, coughs, or talks.

03:31 The droplets are then picked up by the hands, where they can survive and spread for several hours onto objects or toys, which are also known as fomites.

03:40 Imagine this in a daycare setting.

03:42 The infection will spread like wildfire.

03:46 Once a person touches the contaminated shared object, including the utensils, the toys, doorknobs, counter tops, you name it, they can easily acquire the infection by then touching their eyes, nose, and mouth.

03:58 A patient with bronchiolitis is most contagious early on in their illness, and when a fever is present.

04:04 These patients should be isolated away from other children until they're feeling better, and they've been fever free for at least 24 hours.