You Decide: Steroids for Bronchiolitis?

The fascination with steroids is second only to the fascination with antibiotics.  In other words, if antibiotics are the most overused medications in kids, steroids come in a very close second.  As with antibiotics, steroids definitely have a critical role in the treatment of certain illnesses, like asthma.  In fact, countless lives have been improved by short courses of steroids to control severe asthma symptoms.  More countless lives have probably even been saved by steroids.  However, it seems to me that doctors Read more

You Decide: Breathing Treatments for Bronchiolitis?

When kids are having an asthma attack they generally have wheezing.  This asthma-associated wheezing can be treated with a breathing treatment that has a bronchodilator medication (like albuterol).  Since the breathing treatments make the wheezing better in asthma, some doctors have concluded that they might also help with wheezing in bronchiolitis.  Even though this sounds rational, there is absolutely no evidence that this approach has any benefit at all.  In fact, most of what I have read over the years seems to suggest the exact opposite. Read more

Understanding Bronchiolitis

These posts are for the truly Smart Parent that wants to avoid doing things that are unnecessary, wasteful, and perhaps even harmful to their child.  Bronch-iol-itis is different from bronchitis.  One of the primary differences is that bronchiolitis tends to affect young children and bronchitis tends to affect adults (especially smokers).  It is generally not serious but there is a shocking amount of misinformation Read more

Practicing What I Preach…

To avoid complete hypocrisy, I try to make sure I practice at home, what I preach in the ER.  I will admit that there is definitely a strong cultural motivation to “do something” when our son is not feeling well.  However, I always try to remember that in some cases the best thing you can do is to do nothing at all.  With this in mind, a few weeks ago I had the chance Read more

You Decide: Anti-Nausea Medicine #2 – Zofran

Have you heard of this medication?  If not, I am sure you soon will as most people (especially doctor-types) are touting it as the latest and greatest thing since sliced bread.  While it certainly has a role as an anti-nausea medication, many are now advocating its routine use for common pediatric problems.  In particular it has recently become in-vogue to use this medication Read more