Which therapy is not routinely recommended in bronchiolitis management?

• A. Nasal suctioning
• B. Oxygen therapy
• C. Bronchodilators
• D. Hydration

Answer: (C)

In bronchiolitis, the priority is supportive care for a viral infection that causes inflammation and edema in the small airways. Clearing secretions and maintaining adequate hydration and oxygenation are key. Nasal suctioning helps remove nasal secretions, which reduces work of breathing and improves feeding and comfort. Oxygen therapy is given when oxygen saturation drops to prevent hypoxemia, ensuring the child stays well oxygenated. Hydration is important to prevent dehydration and to keep secretions from becoming too thick. Bronchodilators, which relax airway smooth muscle, don’t reliably improve outcomes in bronchiolitis because the airway obstruction is mainly from inflammation and mucus buildup rather than reversible bronchospasm. For this reason, they aren’t routinely used; they may be tried in specific cases where a child has a history of reactive airway disease or if there is a convincing positive response, but that’s not standard practice for most patients.