A 4-month-old has had 3 days of coryza, then a wheezy cough and feeding difficulty. Oxygen saturation is 88 percent in air. What is the appropriate management?

Answer and explanation

Correct answer: A. Admit and give supplemental oxygen, with supportive feeding

  1. Step 1: These features indicate bronchiolitis with hypoxia.
  2. Step 2: NICE NG9 advises oxygen if saturation is persistently below 90 percent (below 92 percent in babies under 6 weeks or with an underlying condition), and supportive care, because antibiotics and bronchodilators do not help.
Answer
Admit and give supplemental oxygen, with supportive feeding.
Why not the others: Chest physiotherapy twice daily with no oxygen or monitoring in hospital: Chest physiotherapy is not recommended. Oral amoxicillin and discharge on the same day with a leaflet for the parents: Antibiotics do not help viral bronchiolitis, and hypoxia needs admission. Regular salbutamol by spacer and oral dexamethasone, then discharge home: Bronchodilators and steroids have no proven benefit.

Practise more Emergencies and acute illness.

Free questions with an explanation for every one, and full timed PLAB 1 (GMC, international medical graduates) mock tests.

All Emergencies and acute illness questionsTake a mock test

More Emergencies and acute illness questions