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Old 03-07-2019, 07:02 AM
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Default Have You Excluded for Bronchiolitis?

I have a 6 month old diagnosed with bronchiolitis. Everything I'm reading says it could take weeks for breathing to go back to normal. Obviously I can't exclude that long, or would you? Need some advice.
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Old 03-07-2019, 07:07 AM
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I'm assuming the child needs breathing treatments?
The child does not have documented asthma?
What's your medication policy?

If it were me, I wouldn't take the child until the breathing is normal because I won't do breathing treatments unless the child has a documented condition (DR's directive) that requires it for life saving measures.

If they are sick enough to need meds, they stay home.
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Old 03-07-2019, 07:10 AM
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Disposition? Happy or cranky struggling to breath?

If baby has been on meds (if any) for a min of 24 hours, the parent is close by AND you feel comfortable taking baby back into care I would.

I'd just watch for anything type of breathing or struggling to breath (whistling or wheezing, shallow breaths etc) that makes you nervous and any other symptoms that would indicate exclusion. Fever, diarrhea, vomiting, irritability etc....

Here is the info my state gives me:
https://www.hennepin.us/-/media/henn...2262263D671EF8
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Old 03-07-2019, 07:20 AM
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I might not exclude because I have an intubation kit and experience. I would not recommend it for others, though. This is one of the most feared calls in EMS. When it's good it's great, when it is bad, it goes bad fast and dark. Group child care is not a good setting for this. I am assuming the child has completed treatment or the ped wound not have signed off on it?
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Old 03-07-2019, 07:20 AM
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Thank you both. The child went to the Dr yesterday but Dr did not give any medications or breathing treatments and just told Mom to observe. I just didn't even think of following up because when mom called in yesterday she told me she just had a cough and I didn't think it was a big deal since she was not coughing at daycare the day before so I learned all this upon arrival this morning. She says baby is happy and eating normally. I did witness labored breathing before I put her down for nap this morning but now that she is sleeping she sounds ok. Just worried about being contagious because my nurse friend says this is often associated with RSV at this age and time of year.
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Old 03-07-2019, 07:22 AM
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Quote:
Originally Posted by Indoorvoice View Post
Just worried about being contagious because my nurse friend says this is often associated with RSV at this age and time of year.
It is because it's respiratory related but honestly I just exclude for symptoms and leave the rest. The contagious period is before and after so like all viral illnesses, there isn't a whole lot you can do to eliminate it. Excluding for symptoms listed on your illness policy simply helps stop the continual rotation but it doesn't really eliminate the fact that others were exposed.
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Old 03-07-2019, 07:27 AM
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Quote:
Originally Posted by Indoorvoice View Post
Just worried about being contagious because my nurse friend says this is often associated with RSV at this age and time of year.
I also would be concerned about this. Have you had your updated RSV immunization?
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Old 03-07-2019, 07:36 AM
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Quote:
Originally Posted by Cat Herder View Post
I also would be concerned about this. Have you had your updated RSV immunization?
No I honestly didn't know that was a thing!
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Old 03-07-2019, 07:41 AM
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Quote:
Originally Posted by Indoorvoice View Post
No I honestly didn't know that was a thing!
Your PCP can give it to you. Mine left a little knot for a couple of days, but since I keep mostly infants it is highly recommended. https://www.fiercepharma.com/vaccine...s-fast-tracked

That and the one for Pertussis: https://www.childhoodhealth.com/clin...d-to-know.html
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Old 03-07-2019, 07:47 AM
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Quote:
Originally Posted by Cat Herder View Post
Your PCP can give it to you. Mine left a little knot for a couple of days, but since I keep mostly infants it is highly recommended. https://www.fiercepharma.com/vaccine...s-fast-tracked

That and the one for Pertussis: https://www.childhoodhealth.com/clin...d-to-know.html
I have a compromised immune system due to meds I'm on so maybe I should look into this. This time of year is really rough on me.
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Old 03-07-2019, 07:53 AM
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https://www.mountnittany.org/articles/healthsheets/1666 : Discharge Instructions for Bronchiolitis (Pediatric)
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Old 03-07-2019, 08:31 AM
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Quote:
Originally Posted by Cat Herder View Post
I might not exclude because I have an intubation kit and experience. I would not recommend it for others, though. This is one of the most feared calls in EMS. When it's good it's great, when it is bad, it goes bad fast and dark. Group child care is not a good setting for this. I am assuming the child has completed treatment or the ped wound not have signed off on it?
This. I would exclude. My youngest has accompromisef immune system so when she got bronchiolitis it went from fine at pediatrician in the morning to ER by the afternoon, to a 3 day hospital stay. Granted Hers was extreme case, but it went bad fast and she was turning blue when we arrived at hospital because of her labored breathing. It went bad super fast.

6 months is still so young, I wouldn’t be able to leave her side for fear or sids which means she should be home.
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Old 03-07-2019, 09:38 AM
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Maybe DCM will be eligible for FMLA? https://www.dol.gov/whd/forms/WH-380-F.pdf
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