'Tis the Season for RSV
Susan
Hamilton-Bruno, RN, MS
As a pediatric critical care clinical nurse specialist in the
Medical/ Surgical Intensive Care Unit at Children's Hospital Boston,
I never look forward to the return of the winter viral season,
primarily because of one culprit: respiratory syncytial virus
(RSV). It is hard to predict how intense this virus will hit in
any given year, so Children's ICU always prepares for an influx
of RSV patients by reviewing infection control procedures and
updating staff on current RSV management strategies.
It is estimated that as many as 126,000 U.S. children under 1
year old are hospitalized with RSV every year. Infants considered
at highest risk are those with underlying chronic conditions such
as prematurity, congenital heart disease or lung disease. Any
infants who fit into these high-risk categories or have extreme
tachypnea, wheezing or respiratory distress, consolidation on
chest x-ray, or overall toxic appearance should be referred for
possible admission.
Care for RSV continues to be mostly supportive. Approximately
two percent of all patients hospitalized require mechanical ventilation.
Indications for intubation include apnea, severe desaturation
episodes or respiratory failure evidenced by elevated carbon dioxide
and decreased oxygenation on arterial blood gas. Care is directed
at maintaining oxygenation, assuring adequate hydration and providing
symptom relief. Since severity of infection and response to treatments
varies greatly, each infant treated for RSV at Children's has
an individualized plan of care.
It is important for all healthcare providers to make the general
public aware of the risks of RSV in infants. New parents of infants
born in the high-risk months should receive information about
the importance of good hand washing and other strategies to protect
their infants. Although clinical professionals are well aware
of the necessity of infection control practices, the vulnerability
of our patients during this season is a good reason for us to
refresh our own precautions against the spread of the infection.
