pediatric-ai-scribe-v3/test/fixtures/deck-reply-early-close.json

{"title":"Bronchiolitis in Infants Under 12 Months","subtitle":"Assessment and Admission Criteria","date":"2024-06-01","slides":[{"type":"section","heading":"Introduction to Bronchiolitis"},{"type":"bullets","heading":"Overview of Bronchiolitis","bullets":[{"text":"Common viral lower respiratory tract infection in infants <12 months"},{"text":"Most frequently caused by Respiratory Syncytial Virus (RSV)"},{"text":"Peak incidence between 2-6 months of age"},{"text":"Characterized by inflammation, edema, and mucus in small airways"},{"text":"Seasonal peaks in fall and winter months"}],"notes":"Introduce bronchiolitis as a common and important condition in young infants, emphasizing viral etiology and typical age group."},{"type":"figure","heading":"Clinical Features of Bronchiolitis","bullets":[{"text":"Initial symptoms: rhinorrhea, mild cough, low-grade fever"},{"text":"Progression: increased cough, wheezing, tachypnea"},{"text":"Signs of respiratory distress: nasal flaring, chest retractions, grunting"},{"text":"Feeding difficulties and irritability common"},{"text":"Apnea may occur in very young or high-risk infants"}],"image_prompt":"schematic infant with highlighted nasal flaring, chest retractions, wheezing lungs, and feeding difficulty icons"},{"type":"compare","heading":"Assessment: Mild vs Severe Bronchiolitis","columns":[{"label":"MILD","bullets":["Normal or mildly increased respiratory rate","No or mild chest retractions","Feeding well, >50% usual intake","No or mild hypoxia (SpO2 ≥ 92%)","Alert and consolable"]},{"label":"SEVERE","bullets":["Marked tachypnea (>70 breaths/min)","Moderate to severe chest retractions and nasal flaring","Feeding poorly, <50% usual intake or vomiting","Hypoxia (SpO2 < 92%) or cyanosis","Lethargy, apnea, or altered consciousness"]}]},{"type":"table","heading":"Admission Criteria for Infants with Bronchiolitis","header":["Criteria","Indication for Admission"],"rows":[["Respiratory distress (severe retractions, grunting)","Admit for monitoring and supportive care"],["Hypoxia (SpO2 < 92%) on room air","Admit for oxygen therapy"],["Poor oral intake (<50% usual) or dehydration","Admit for IV fluids"],["Apnea or history of apnea","Admit for close monitoring"],["Underlying risk factors (prematurity, chronic lung disease, congenital heart disease)","Lower threshold for admission"],["Age < 3 months with bronchiolitis","Consider admission due to higher risk"]]},"notes":"Use this table to guide decisions on when to admit infants based on clinical severity and risk factors."},{"type":"callout","heading":"Key Red Flag","text":"Apnea or cyanosis in any infant with bronchiolitis requires urgent admission and monitoring."},{"type":"bullets","heading":"Summary and Management Principles","bullets":[{"text":"Supportive care is mainstay: oxygen, hydration, and monitoring"},{"text":"Avoid routine use of bronchodilators, steroids, or antibiotics"},{"text":"Educate caregivers on signs of deterioration"},{"text":"Close follow-up for infants discharged home"},{"text":"Consider admission for infants meeting criteria or with social concerns"}],"notes":"Reinforce that management is mostly supportive and highlight importance of caregiver education and follow-up."},{"type":"table","heading":"References","header":["Source"],"rows":[["American Academy of Pediatrics Clinical Practice Guideline, 2014"],["NICE Guideline NG9, Bronchiolitis in children, 2015"],["UpToDate: Bronchiolitis in infants and children"]]}]}