Bronchiolitis / Wheezing – 3-24 Months

Wheezing is a common complaint on radio traffic. In infants, wheezing is most likely due to bronchiolitis or asthma. Listen carefully for a history of recurrent wheezing in the past as a clue toward asthma. For infants presenting for the first time or with associated stridor, think foreign body. Wheezing in older children should not be diagnosed as “bronchitis” as this is not a disease seen in children. Older wheezing children have asthma, a viral process or pneumonia. Be tuned in to a reported past history that points to undiagnosed bronchiectasis (productive cough greater than 3 months). These children should be seen in Pediatric Clinic for an evaluation.

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Resources/References

• Lewis, T. et al. Prevalence of Asthma and Chronic Respiratory Symptoms Among Alaska Native Children. CHEST. 125(5):1665-1673, May 2004. doi.org/10.1378/chest.125.5.1665
• Respiratory Hospitalizations in the Delta (Powerpoint Presentation by Rosalyn Singleton, MD)
• Bronchiolitis/Wheezing YKHC Clinical Guideline

category:YKHC Guidelines
Common/Unique Medical Diagnoses