'Tis the Season for RSV
Susan Hamilton-Bruno, RN, MS

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.