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Respiratory Outpatient Clinic (ROC)

Updated: December 2, 2020

Due to the COVID-19 pandemic, the Respiratory Outpatient Clinic (ROC) locations will remain closed this fall and winter. Because the suction performed during a ROC visit is an aerosol-generating procedure, it could allow tiny virus particles into the surrounding air. With COVID-19 this would require more staff and resources than are currently available to keep patients, families and employees safe.

What resources are available?

Our urgent care locations are available for telehealth and in-person visits seven days a week: Monday – Friday, Noon – 10 p.m.; and weekends, 10 a.m. – 8 p.m. Telehealth visits can help you determine if your child needs to be seen for in-person care. Select a visit time and check-in online using Save My Spot.

The Respiratory Care team has developed this guide on how to use a manual nasal aspirator to help parents provide suction for their infant at home.

How to use a manual nasal aspirator (PDF)
Cómo usar un aspirador nasal manual (PDF)

If a step-by-step tutorial in needed, please search for the manufacturer video for the suction product owned.

What is bronchiolitis?

Bronchiolitis is the most common cause of hospitalization in patients less than 2 years of age. It is a viral infection of the lower respiratory tract. The small breathing tubes in the lungs (bronchioles) fill with mucus, which can make it difficult to breathe. It often is caused by respiratory syncytial virus (RSV). It can also be caused by rhinovirus, influenza, human metapneumovirus or many other viruses. It starts with “common cold” symptoms such as runny nose, fever and cough. Wheezing is very common. It is part of the viral illness and does not mean your child has asthma. Poor feeding might occur because of a stuffy nose or trouble breathing. Prematurity or underlying health problems may lead to more severe illness.

How was my child diagnosed with bronchiolitis?

Health care providers usually diagnose bronchiolitis by talking to you about your child’s illness and examining your child. In most cases, blood work, X-rays and virus tests will not change your child’s treatment. Tests for specific viruses are not always accurate.

Is there any medicine to help my child get better faster?

There are no medications to treat the virus, as antibiotics do not treat viruses. The illness needs to “run its course.” Most patients with bronchiolitis are not helped with albuterol treatments, and cough/cold medications are not beneficial and may have side effects.

How can I help my child at home?

  • Use a bulb syringe or other manual nasal aspirator (i.e. Nose-Frida, Nasakleen, etc.) to suction mucous from the nose. Put two drops of nasal saline (saltwater) in each nostril before suctioning. This may help remove more mucus.
  • Suction before feeding, before sleeping or if your child appears uncomfortable.
  • Make sure your child drinks plenty of fluids. Your child may drink smaller amounts than normal. Give fluids more frequently.
  • Do not let anyone smoke near your child. This can make his or her symptoms worse.
  • Acetaminophen and (for children over 6 months) ibuprofen can be used for fever and fussiness.
  • Wash your hands often to help prevent spread of the virus to others.

When should I bring my child back for bronchiolitis?

Your child should be seen for:

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Difficulty breathing

  • Sinking in above, below or in between ribs
  • Breathing faster than once per second
  • Trouble eating, due to congestion
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Fever higher than 101 for more than five days

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Signs of dehydration (no tears, dry mouth or fewer wet diapers)

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If you have any other concerns

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Contact your child’s regular doctor or call the Children’s Mercy Nurse Advice Line: (816) 234-3188

New! Our urgent care locations are available for telehealth and in-person visits seven days a week:

  • Monday – Friday, Noon – 10 p.m.
  • Weekends, 10 a.m. – 8 p.m.
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  • Telehealth visits can help you determine if your child needs to be seen for in-person care
  • Select a visit time and check-in online by going to Save My Spot

Cough and congestion may last for up to 14 days. Remember to follow up with your child’s health care provider if you believe additional care is needed.

Suctioning for bronchiolitis – FAQ for parents

Below are answers to frequently asked questions we receive about suctioning for bronchiolitis.

These are available for purchase from many pharmacies and online retailers. They may help with the ease of suctioning mucous from your child’s nose.

You can suction your child’s nose at any age. Suction should only be applied for a few seconds at a time, allowing for your child to catch their breath in between suctioning. It is most effective for children under the age of 2, when they can’t blow their nose effectively yet.

If your child has thin mucous (boogers), it may not be necessary to use saline. You can use a couple of drops of saline if your child has thick secretions (boogers). Two drops in each nostril should be enough to thin out the mucus.

You may see the following:

  • Sinking in above, below or in between ribs

  • Faster than 1 breath per second

  • Trouble eating, due to congestion

It may help to swaddle the baby with a blanket. If you have a helper, they may be able to hold the baby comfortably for you while you suction the nose.

You should continue to suction intermittently as long as you are continuing to retrieve mucous with suctioning. It is especially important to continue to suction intermittently if your baby looks like they breathe more comfortably and eat better after suctioning. It may help to have another caregiver swaddle your baby and hold them comfortably during suctioning.

In most cases, suctioning is most helpful before feeding and before sleeping.

Not necessarily. Cold air is typically dry and may cause thickening of mucous (boogers), making them harder to retrieve while suctioning.

Using a humidifier may help to thin your child’s mucous (boogers). However, you will want to make sure to strictly follow the cleaning recommendations by the manufacturer. If the humidifier isn’t cleaned properly it can lead to mold growth. Also, ensure cleanliness of other surroundings, and avoid placing the humidifier on a carpeted floor.

Most manual suction devices work similarly, we don’t endorse one product over another. Make sure to read all instructions carefully and use your suction device as per the manufacturer’s recommendations.