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Bronchiolitis, the annual winter endemic of acute viral lower respiratory tract illness in infants, is challenging for hospitals with overfull paediatric wards, for general practitioners worried about not spotting the infant at risk and for sleep-deprived parents looking after a sick child. The National Institute for Health and Care Excellence (NICE) Bronchiolitis guideline, published in 2015,1 highlights ‘red flags’ and lists ineffective treatments which ‘should not be used’, citing abundant clinical trials.
In this journal, Carande and colleagues2 gauge the effect of the guideline publication on management in general practice. There were some shifts towards better practice in the (self-selected) general practitioner (GP) respondents, though improvement was incremental rather than transformational, as is common to new guidelines.3
Nearly three-quarters of respondents routinely used oximetry for the assessment of a child with acute bronchiolitis. Measuring oxygen saturation with an age-appropriate device has been widely promoted as essential in the assessment of patients of any age with acute lower …
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