RSV Bronchiolitis Emergency Management
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- Опубликовано: 31 июл 2022
- In this video we present an infant with RSV bronchiolitis who was treated with albuterol and atrovent, racemic epinephrine and 3% hypertonic saline nebulizations as well as suctioning. The patient improved markedly after the treatments and was discharged home. This is an updated version of a recently published video that is being replaced.
The evidence that the 2014 AAP Bronchiolitis Guidelines and multiple international guidelines were significantly flawed from the start is strong and is growing every year. The consequences and challenges caused by these flawed guidelines for the frontline clinician have been huge. This video hopes to serve as a call for our national and international organizations to revisit the guidelines and better align their recommendations with the current evidence.
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You are exceptional Dr. Mellick!
My CCME EM Boot Camp referenced you and your videos. Good News is I've been watching you for years! Its good to know that other clinicians can benefit from your teaching.
Thank You!!
Cool! Thanks so much for the words of encouragement! I very much appreciate it.
Your videos have been and continue to be of tremendous effect on my spirit, Dr. Mellick.
I write as a Physician currently practicing in sub-Saharan Africa, Nigeria, where a doctor most times finds himself as the be-all for his patient; especially in the more rural areas of practice.
Thank you so much for your comments. Your kind words are a huge inspiration and encouragement. Thanks again. I have the upmost respect for physicians like you!
@@lmellick God bless!
You can hear in Dr. Mellick's voice how much he loves children 🫠🥰
Just graduated nursing school, taking my NCLEX this weekend. Love watching your videos. Never drop learning.
Former Critical Care Nurse, turned Nurse Manager and i always watch. You never stop learning in this field. Good luck with your NCLEX
Thank you! So glad they are helpful.
@@lmellick very helpful, especially when i finish my Acute care NP. Your videos always explain everything very professionally, and are great aids. Thank you so much for what you do
@@putthefuinfun1947 Thank you so much for the well wishes! I will report back with my results!
This is the exact treatment protocol we use in our EMS system for this situation . We have had good outcomes and patients with bronchiolitis going home from the ED within hours 😀
I 100% agree with this modality. I always knew anecdotally that treatment was beneficial and never really understood the updated guidelines. Particularly agree with: "future ... guidelines should avoid recommending against potentially helpful treatments until more conclusive evidence is available."
I think this debacle of a guideline nationally and internationally should become exhibit A for "how not to write guidelines" for future writers of guidelines.
these videos are amazing
Thank you!!
My little one is 22 months and is on day 5 of admission w/RSV labored breathing and wheezing & he responded well to the albuterol in the beginning but not sure they used the epinephrine... about 2 days ago they had to stop albuterol because it started lowering his stats.
That's because no true clinicians wrote those guidelines. Thank you, Professor Melick, once again!
You are welcome!
Love all your Videos Doc. I hope we have something like this in Psych!
Thank you!!
Poor little guy. I hope he gets better soon he’s so gorgeous love from Australia
Thank you!
Poor little guy. Dr. Mellick making the world a better place! (I'm serious). Had a nasty bout with a possible novel RSV in early 2019 . 6-8 weeks and nothing touched it. NASTY. I can relate to how that little guy was feeling.
Thanks!!
Hii i just saw one of your rabies vaccine video. I took a rabies vaccine today its prepared on vero cell . Actually i am worried about the side effects from vaccine. I have to take 5 of these
Bronchodilators don't work for RSV. A wise RT on my inpatient peds said to me "It's RSV man this shit [bronchodilators] don't work." Suctioning and as needed oxygen is the treatment, that's it.
came here to say the same
it's not curative but as the aforementioned studies reflect-it can at the very least help transiently in moderate to severe cases of bronchiolitis.
It's amazed me for a long time how american medical society have always considered a bunch of diseases as one disease that they call "bronchiolitis" The europeans got this one much more accurate. They distinguish between 'obstructive bronchitis', which is quite easy to treat with brochodilators, and true 'bronchiolitis' which usulally affects toddles , responds poorly to bronchodilators, and is cause specifically by RSV. This distinction is very useful on the floor. All sorts of meta-analysisthat are grouping a number of disease under one umbrealla of 'bronchilitis' will almost always come a wrong conclusion depending of how many true bronchiolitis patiens they include. Someone should already have the balls to call this out! How about you prof. Melick?
Agree! I am working on calling this out. Hopefully, will have some data soon that will serve as the coup de gras on these flawed guidelines.
Martin I’m in nursing school right now and they’re teaching a clear distinction between obstructive bronchitis and bronchiolitis. Maybe this was accurate in the past but it’s not anymore.
@@CockTortureJutsu Good to hear
@@lmellick Thank you great doctor
Poor babe hope he she’s better soon
He did very well.
It could aswell be a viral induced wheeze..the age of the child is almost at the cut off. Beta agonists should be effective
First!
Congrats!