By this time in the year, everyone has likely seen quite a bit of bronchiolitis. We’ve have tried suctioning, nebulizers, maybe even steroids, and the baby is still grunting and working hard to breathe. What next besides routine humidified oxygen or intubation? Is there any bridge therapy to prevent the intubation? Non-invasive ventilatory strategies like continuous positive airway pressure (CPAP) have been employed in the treatment of bronchiolitis, and they have been shown to be useful at preventing intubations and improving ventilation. However, CPAP may be technically difficult to use and is sometimes poorly tolerated by small children and infants. What about high flow nasal cannulae oxygen therapy (HFNC)? There is little data with its use in bronchiolitis, but one recently published study addresses this very question.

Is the radiology department changing its mind after your patient is discharged?

Until we start educating patients about what really affects their health and what a doctor is capable of fixing, we will continue to waste a large portion of our healthcare dollar on treatments which just don’t make any difference.

 

 

 

For camaraderie and a dose of perspective, try organizing a medical humanities night for your ED

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