Lower Respiratory Tract Infection

Most common lower respiratory tract infection in children under 2 years old.


tachypnoea, over inflation of chest, retractions, wheezes, crackles

Treatment guidelines:

Bronchodilators; no clinical benefit and some indication that may cause clinical deterioration in arterial oxygen saturations

Adrenaline; could help in acute severe case, particularly as a bridge until further support can be obtained.

Steroids; not recommended in any form.  

Antibiotics; not routinely used unless high index of suspicion of secondary bacterial infection.

Oxygen; only for oxygen saturations below 90%

IV fluids; as needed

Feeding; PO intake should be held if child is breathing greater than 60 times a minute.

RSV symptoms are rhinorrhea, nasal congestion, cough and fever

Disease process usually runs 10-14 days with days 3-5 having the worst symptoms.

40% of all RSV progresses to bronchiolitis.

Treatment for RSV is same as for bronchiolitis.

REFERENCE:  AAP subcommittee on Diagnosis and Management of Bronchiolitis. Pediatrics 2006 Oct;118: 1774-93

RSV: Management of the acute episode. Pediatric Respiratory Reviews; 2000: 215-220.

For more information, please contact:

Jason Herold, Pediatric Transport Coordinator
Medical Center at Augusta University