We distributed the recent AAP guidelines for the management of bronchiolitis to our pediatric group but still find the inertia of routinely administering albuterol hard to reverse. What is the international experience?
Your colleagues' inertia is probably a good thing. Albuterol in our RCT decreased admission by 18% compared to epinephrine. At the very least it is worth an adequate trial to gauge the infants response.
The link below highlights some of the problems with the new guideline. The RCT is also open access complete with dataset.
odd, idk why the link didn't show. Here is the doi
10.5811/westjem.2015.1.24930
Here we experience the same problem. As we have no proper therapeutic measures to apply, we end up administering salbutamol (in our case) to almost all infants. However, we've been using saline in almost all cases, with apparent good results.
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