It's RSV Time Again
This contagious virus spreads through the air and through surface contact.
By Marven Ewen, MD
It’s that time of year again: winter. With it comes seasonal medical conditions such as viral bronchiolitis. This is a condition common in young infants, usually under the age of one, where the very small airways (bronchioles) become inflamed. It is caused by a virus, most often Respiratory Syncytial Virus, usually referred to as RSV.
This is a very contagious virus which spreads both by aerosol droplets and on surfaces. Adults can also get it, but usually they get milder symptoms. Remember PPE on any call involving a virus to best protect yourself.
RSV symptoms can last for several weeks, prompting many parents to see their doctor for antibiotics; however, antibiotics don’t treat viruses and are not indicated for this condition. I can’t tell you how many times I have had this conversation with parents who seem very hesitant to accept this fact.
Fortunately, most kids that get this infection don’t develop respiratory distress unless they have risk factors. Those at higher risk include kids with congenital heart disease, depressed immunity, and premature infants. Some of these patients will end up in the hospital for treatment.
Signs & Symptoms
Typical symptoms appear like any viral cold: runny nose, fever, cough. Those that become more ill will begin to show signs of respiratory problems. In babies, respiratory distress can present as lethargy, poor feeding, nasal flaring in inspiration, and as the condition gets worse, grunting, tachypnea, tachycardia, and intercostal/supraventricular retractions develop. You can often hear wheezing on auscultation.
Assessment & Emergency Care
You should have some idea of the normal range of vitals in a baby - a baby’s normal respiratory rate is 30-60, and is often irregular with pauses of several seconds, so you need to measure for at least 30 seconds and often measuring over a full minute is best. Normal pulse in a baby under a year of age is about 90-160, and best checked at the brachial artery on the inside of the upper arm. And remember assessment isn’t just about numbers - does the baby look ill?
Every EMT should be able to recognize respiratory distress. If you are seeing signs of respiratory distress then start high flow oxygen as soon as you recognize it. Albuterol neb can be tried, but is often not effective for this condition. Oxygen is what a baby in respiratory distress needs immediately.
Risk of Asthma
As an interesting aside on this topic, children that had RSV as infants have higher incidence of asthma later in childhood. It is not known whether this is a causal relationship, or if the kids who got bronchiolitis were at a higher risk for it because of their predisposition for asthma.
More from The Allied Times
Raynaud’s PhenomenonThe vascular condition where cold fingers and toes aren’t just from winter weather.By Jenny Ewen, BA, NREMTEditor-In-ChiefOverviewAs the winter season settles upon us, feeling cold is a pretty common occurrence. Blood vessels near the surface of the skin will constrict when exposed to cold in order to push blood deeper in the body and…
Stress Eating: An Emotional Blackhole Stress and overeating can go hand in hand, but prevention is possible.By Mariah Xzena Briones, RMTCertification SpecialistAre your cravings immensely increasing when you’re bombarded with never-ending tasks at work? Have you noticed your study table being more occupied with snacks than books especially during exam week? Food cravings and increased…
A Trip to Africa The threat of malaria must be considered when traveling.By Marven Ewen, MDMedical DirectorOne evening an aspiring 40 year old nature photographer was brought to the ER. He was feeling ill with intermittent fever for several days. He had malaise, arthralgias, a headache, and episodes of delirium. No one else in the…
Carpal Tunnel Syndrome Early diagnosis is key to stopping progression of this condition.By Mariah Xzena Briones, RMTCertification SpecialistEMTs must use their hands and wrist to carry patients or move heavy objects for rescue operations. When the patient is critical for both time and condition, EMTs prioritize their patients and sometimes overuse their hands and wrists…
The Hidden Stroke Atrial fibrillation can be the culprit behind embolic stroke.By Marven Ewen, MDMedical DirectorJohn is a busy 58-year-old accountant who, during the previous week, had been feeling more tired than usual but thought he might be coming down with some sort of virus; however, the usual symptoms of a cold such as nasal…
Anti-NMDA Receptor Encephalitis The neurological condition resulting in sudden and severe behavioral changes. By Jenny Ewen, BA, NREMTEditor-In-Chief OverviewFirst identified in 2007 by Dr. Joseph Dalmau, anti-NMDA receptor encephalitis is an auto-immune disease where antibodies attack the NMDA receptors in the brain (specifically the GluN1 subunit), causing a litany of symptoms due to the…