Return to NG9 Overview

Bronchiolitis in children: diagnosis and management [NG9]

Measuring the use of this guidance

Recommendation: 1.2.1

Immediately refer children with bronchiolitis for emergency hospital care (usually by 999 ambulance) if they have any of the following: -apnoea (observed or reported) -child looks seriously unwell to a healthcare professional -severe respiratory distress, for example grunting, marked chest recession, or a respiratory rate of over 70 breaths/minute -central cyanosis -persistent oxygen saturation of less than 92% when breathing air.

What was measured: Proportion of GPs who are compliant with NICE guidance on referring children to hospital if oxygen saturations are less than or equal to 92% (excluding those who only referred once saturations are less than or equal to 90% or 88%).
Data collection end: March 2015
25%
Area covered: UK
Source: Nickless A, Galiza E P, Pollard A J, and Drysdale S B. (2017). Benchmarking of Viral Bronchiolitis Management by General Practitioners in the United Kingdom. Pediatric, Allergy, Immunology, and and Pulmonology, 30, pp.69-73.


Recommendation: 1.2.2

Consider referring children with bronchiolitis to hospital if they have any of the following: -a respiratory rate of over 60 breaths/minute -difficulty with breastfeeding or inadequate oral fluid intake (50–75% of usual volume, taking account of risk factors [see recommendation 1.3.3] and using clinical judgement) -clinical dehydration.

What was measured: Proportion of GPs who are compliant with NICE guidance on referring children to hospital if feeding was less than or equal to 50% (excluding those who only referred once feeding was less than or equal to 33%).
Data collection end: March 2015
56%
Area covered: UK
Source: Nickless A, Galiza E P, Pollard A J, and Drysdale S B. (2017). Benchmarking of Viral Bronchiolitis Management by General Practitioners in the United Kingdom. Pediatric, Allergy, Immunology, and and Pulmonology, 30, pp.69-73.


Recommendation: 1.4.3

Do not use any of the following to treat bronchiolitis in children: antibiotics hypertonic saline adrenaline (nebulised) salbutamol montelukast ipratropium bromide systemic or inhaled corticosteroids a combination of systemic corticosteroids and nebulised adrenaline.

What was measured: Proportion of children referred to paediatric intensive care unit with bronchiolitis where any Nebuliser was used.
Data collection end: March 2016
53%
Number that met the criteria: 81 / 153
Data collection end: March 2016
53%
Number that met the criteria: 81 / 153
Area covered: Local
Source: Griffiths, Benedict; Riphagen, Shelley; Lillie, Jon, Management of severe bronchiolitis: impact of NICE guidelines, Archives of disease in childhood, , 2018.



 Return to NG9 Overview