Tutorial presented by Dr David Miller, GP and Assistant Medical Director for Primary Care, CTMUHB.

In this tutorial, David outlines the Assessment of an infant presenting to primary care with suspected RSV bronchiolitis. Throughout the tutorial, David refers to the All Wales guideline for the Primary Care Management of RSV Bronchiolitis, linked below.

When assessing a child with a respiratory illness, the diagnosis of RSV Bronchiolitis is more likely if:

• Age <1yrs
• A coryzal prodrome lasting 1 to 3 days
• Persistent cough
• Tachypnoea and/or chest recessions
• Crackles and/or wheeze

Once the initial assessment has been completed and RSV bronchiolitis is suspected, the guidance provides three categories of risk severity, low, moderate and severe, using the following key objective measures:

1. Oxygen saturations
2. Feeding volume
3. Work of breathing

If the patient is found to have mild illness, they can generally be discharged home with safety netting.

If the patient is found to have moderate or severe illness, they should be transferred to hospital for assessment.