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Respiratory illnesses shouldn't always require hospitalization, doctors say

Pediatric hospitalists Dr. Kristina McKinley, left, and Dr. Alyson Edmunds, at Riverton Hospital Tuesday, Nov. 8, 2011 in Riverton, Utah.
Pediatric hospitalists Dr. Kristina McKinley, left, and Dr. Alyson Edmunds, at Riverton Hospital Tuesday, Nov. 8, 2011 in Riverton, Utah.
Tom Smart, Deseret News

SALT LAKE CITY — Mothers usually know their own child best. So, if a health concern, especially one that is affecting a child's breathing — like RSV or asthma — is bothersome and worrying, doctors say an office visit wouldn't hurt.

However, an immediate emergency room visit is the best route if a very young baby is running a high temperature, among other respiratory symptoms, and if treatments using the broncho-dilator, albuterol, are not effective.

When available, a child's regular doctor would be the best avenue, "because they know their history and would know which medications have already been tried," Riverton Hospital Children's Unit's Dr. Kristina McKinley said during the Deseret News/Intermountain Healthcare Health Hotline on Saturday.

McKinley and Dr. Alyson Edmunds, both pediatricians at the hospital, answered questions from dozens of concerned mothers Saturday, including those who called in on the toll-free number, from as far away as Seattle, and many who visited the Deseret News Facebook page.

A good portion of the calls and questions dealt with how to know when a doctor visit was necessary and Edmunds mentioned that the biggest concerns needing medical attention would be dehydration, blue coloring around a child's mouth and/or difficulty breathing. But every situation is different, she said.

The doctors provided much detail on the basic symptoms of asthma, RSV and another common respiratory infection, croup.

One mother asked if her son would be able to contract RSV a second time, after he was hospitalized the first time around. McKinley said it is possible, but the older a child gets, the less at risk they are for serious infections that require hospitalization.

While the RSV season has yet to hit Utah, both McKinley and Edmunds have seen an increasing number of patients with the parainfluenza virus, which can lead to the recognizable "barky cough" of croup. Croup is an infection sometimes caused by the parainfluenza virus that particularly affects toddlers and is rare after the age of six, McKinley said. She said the first two days are typically the worst and symptoms should start to subside after that.

"Influenza is a much more serious infection than RSV," she said, adding that flu can and sometimes does lead to death.

To avoid spreading any of the contagious respiratory infections that are seemingly more potent during the winter months, both doctors recommend good hand-washing habits and avoiding people or locations where sickness is apparent.

"Croup is spread to others just like any other cold: coughing or sneezing on others, not washing your hands, sharing drinks. Hand washing is the very best way to prevent the spread of croup and other colds to others," Edmunds said.

The spread of viruses throughout communities in the state of Utah is reported by Intermountain Healthcare hospitals and clinics, via GermWatch, an online database updated by Intermountain officials.

The health hotline is offered to readers through a partnership between Intermountain Healthcare and the Deseret News. It covers a different health topic the second Saturday of each month.

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