An 18 month old is diagnosed with bronchiolitis. What is the most appropriate for initial patient management?

In the management of bronchiolitis, particularly in young children like an 18-month-old, supportive care is the most appropriate initial approach. This condition is typically viral in etiology, most commonly caused by respiratory syncytial virus (RSV), and antibiotics are not effective against viral infections.

Supportive care includes measures aimed at relieving symptoms and may involve the use of antipyretics to manage fever and discomfort. Ensuring the child stays hydrated and monitoring their respiratory status are also crucial components of care. In cases of mild bronchiolitis, infants may be treated with nasal suctioning to clear secretions and ensure their airways remain patent.

Inhaled bronchodilators and inhaled steroids may be considered, but they are not generally recommended for initial management of bronchiolitis, as evidence regarding their effectiveness is inconclusive. Therefore, prioritizing supportive care is the cornerstone of initial patient management in this situation.