PEDIATRIC RSV SIMULATION

Summary

In this video, a nurse evaluates a 3-month-old baby named Mallory, who has been struggling with nasal congestion, difficulty breathing, and poor eating for several days. The nurse examines Mallory’s symptoms, such as upper airway sounds, wheezing, and low oxygen levels. After cleaning her nose and administering medication, the nurse suggests further interventions like IV fluids and higher flow oxygen. Mallory's family history includes previous illnesses, and despite treatment, her condition calls for possible transfer to a higher care facility.

Takeaways

• 😀 Baby Mallory, a 3-month-old, is experiencing respiratory issues, including nasal congestion, difficulty breathing, and a decrease in appetite.
• 😀 Mallory hasn't been eating well, with only one wet diaper reported and a poor feeding intake of around half a bottle at each feeding time.
• 😀 The respiratory symptoms, including a stuffy nose and wheezing, have been ongoing for about five to six days.
• 😀 The nurse attempts to clear Mallory's nose using a syringe, a crucial step since babies primarily breathe through their noses.
• 😀 Mallory's oxygen saturation levels are concerning, as her oxygen levels were in the mid-80s, prompting further action to support her breathing.
• 😀 The baby was given a medication that is similar to adrenaline, which can help open airways but may cause shakiness as a side effect.
• 😀 Mallory's older sibling had a cold a couple of weeks ago, but there is no history of respiratory problems for Mallory prior to this episode.
• 😀 The nurse performs an assessment of Mallory’s upper airway, noting congestion and some wheezing. The airway sounds are indicative of respiratory distress.
• 😀 The nurse explains that Mallory might not like the nasal suctioning process, which can cause her to gag or sneeze, but it’s necessary for her recovery.
• 😀 Mallory’s condition is concerning enough that the medical team decides to initiate IV fluids due to her poor intake and consider transferring her to another facility for higher-level care.

Q & A

What is the main concern the parent has about the baby's health?

The main concern is that the baby, Mallory, is having difficulty breathing due to nasal congestion, is not eating well, and is not producing many wet diapers.

How long has the baby been experiencing respiratory symptoms?

The baby has been experiencing respiratory symptoms, including nasal congestion, for about five or six days.

Why is it important to clear the baby's nose?

It is important to clear the baby's nose because babies primarily breathe through their noses, and nasal congestion can make it difficult for them to breathe properly.

What is the usual feeding amount for the baby, and how is it affected by the current illness?

The baby usually eats about four ounces every four to five hours, but due to the illness, she has barely eaten anything and did not wake up for her feeding this morning.

What medication is given to the baby to help with her respiratory issues, and what is its effect?

The baby is given a medication similar to adrenaline, which helps open up the airways. It may also cause some shakiness as a side effect, but it is effective in relieving the respiratory distress.

Has the baby had a fever or any vomiting?

No, the baby has not had a fever or vomiting, but she has had very little food intake and minimal wet diapers.

What are intercostal and subcostal retractions, and why are they concerning?

Intercostal and subcostal retractions refer to the areas between the ribs (intercostal) and below the rib cage (subcostal) being sucked inward during breathing, which can indicate difficulty breathing and respiratory distress.

What is the significance of the baby's oxygen saturation (in the mid-80s)?

An oxygen saturation in the mid-80s is concerning, as it suggests that the baby is not getting enough oxygen to her body, which may require medical intervention like higher-flow oxygen.

What is the plan to address the baby's respiratory distress?

The plan includes starting IV fluids to address dehydration due to poor feeding, administering high-flow oxygen to improve her oxygen levels, and potentially transferring her to another facility for further care.

Has anyone else in the household been sick, and could this affect the baby?

Yes, the baby's older brother had a cold a couple of weeks ago, and there is a possibility that the baby caught a similar illness, which could be contributing to her current symptoms.