Your Child's RSV Monitoring Care Plan

Key Objectives

To provide parents with advice and information when their child or children have a respiratory syncytial virus (RSV) in a digital care plan. Care plan to be the patient record team

Outcome measures

Equip parents with the information they need when caring for their child at home and give them advice on when to get support, symptoms to track and measurements to monitor to support the outbreak of RSV.

Current Baselines

There isn't a lot of information on RSV and trusts are finding it hard to get RSV information to parents.

Workflow

  1. Carer: Claims their patient PKB record. Giving them the ability to view their child's record

  2. Carer: Adds RSV care plan to child's PKB record

  3. Carer: Ability to edit and share care plan

  4. Clinical team: Views care plan in a virtual appointment to support clinical decision-making

Your child's RSV Monitoring Care Plan Template

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<h2>What is RSV?</h2>

<p>Respiratory syncytial virus (RSV) is a very common respiratory virus that causes lung and respiratory tract infections. It is a highly contagious virus that spreads from person to person through droplets when they cough, sneeze or talk.</p>

<p>RSV is a common virus that almost all children are infected with by the time they're 2 years old. In older children and adults, RSV may cause a <a href="https://www.nhs.uk/conditions/cough/ ">cough</a> or <a href="https://www.nhs.uk/conditions/common-cold/ ">cold</a>, in infants, the virus can cause serious illnesses including <a href="https://www.nhs.uk/conditions/bronchiolitis/ ">bronchiolitis</a> and <a href="https://www.nhs.uk/conditions/pneumonia/ ">pneumonia</a>, an infection of their lung which can lead to hospitalisation.</p>

<h2>Why the NHS is seeing an increase in RSV</h2>

<p>Due to COVID-19 restrictions since March 2020, there has been a decrease in the numbers of RSV and other respiratory viruses due to good hand washing, social distancing and the reduced contact between children. As restrictions are lifted, an increase of RSV cases in children is being seen by the NHS.</p>

<h2>Who's most at risk?</h2>

<p>Several things can increase a child's likelihood of developing the infection.</p>

<p>These include:</p><ul>

<li style="list-style:inherit; margin-left: 15px;">having brothers or sisters who attend school or nursery, as they're more likely to come into contact with a virus</li>

<li style="list-style:inherit; margin-left: 15px;">being under 2 months of age</li>

<li style="list-style:inherit; margin-left: 15px;">having <a href="https://www.nhs.uk/conditions/congenital-heart-disease/ ">congenital heart disease</a></li>

<li style="list-style:inherit; margin-left: 15px;">being born prematurely (before week 37 of pregnancy)</li>

<li style="list-style:inherit; margin-left: 15px;">having chronic lung disease of prematurity (when injury to the lungs causes long-term respiratory problems in premature babies)</li>

</ul>

<h2>Prevention</h2>

<p>The best way to prevent the spread of RSV is to: </p>

<ul>

<li style="list-style:inherit; margin-left: 15px;">stay home and away from toddlers and babies if you are sick</li>

<li style="list-style:inherit; margin-left: 15px;">anyone unwell should stay at home until they are symptom-free and feeling better</li>

<li style="list-style:inherit; margin-left: 15px;">children shouldn't return to childcare or school until they have been feeling well for 24 hours</li>

<li style="list-style:inherit; margin-left: 15px;">good hand hygiene - regularly wash and dry your hands</li>

<li style="list-style:inherit; margin-left: 15px;">cough and sneeze into your elbows, carefully discard dirty tissues</li>

<li style="list-style:inherit; margin-left: 15px;">do not share food and drink</li>

<li style="list-style:inherit; margin-left: 15px;">practise physical distancing</li>

<li style="list-style:inherit; margin-left: 15px;">toys should be washed in warm water and detergent at the end of the day (if they are shared)</li>

</ul>

<h2>Signs and Symptoms</h2>

<ul>

<li style="list-style:inherit; margin-left: 15px;">a runny nose</li>

<li style="list-style:inherit; margin-left: 15px;">coughing or sneezing</li>

<li style="list-style:inherit; margin-left: 15px;">fever</li>

<li style="list-style:inherit; margin-left: 15px;">wheezing and difficulty breathing </li>

<li style="list-style:inherit; margin-left: 15px;">decreased appetite </li>

<li style="list-style:inherit; margin-left: 15px;">loss of appetite or difficulty feeding due to breathlessness</li>

<li style="list-style:inherit; margin-left: 15px;">in very young infants, irritability or decreased activity </li>

<li style="list-style:inherit; margin-left: 15px;">shortness of breath or rapid breathing (this requires immediate medical attention)</li>

</ul>

<h2>Useful information</h2>

<ul>

<li style="list-style:inherit; margin-left: 15px;">What is <a href="https://www.rch.org.au/kidsinfo/fact_sheets/Respiratory_Syncytial_Virus_RSV/ ">Respiratory syncytial virus (RSV)</a></li>

<li style="list-style:inherit; margin-left: 15px;"><a href="https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/respiratory-syncytial-virus-rsv ">Symptoms, treatment and prevention of RSV</a></li>

<li style="list-style:inherit; margin-left: 15px;"><a href="RSV (Respiratory Syncytial Virus): What Parents Should Know ">RSV (Respiratory Syncytial Virus): What Parents Should Know</a></li>

<li style="list-style:inherit; margin-left: 15px;"><a href="Caring for a child with fever | NHS ">Caring for a child with fever | NHS</a></li>

<li style="list-style:inherit; margin-left: 15px;"><a href="How to take your baby's temperature ">How to take your baby's temperature</a></li>

<li style="list-style:inherit; margin-left: 15px;"><a href="High temperature (fever) in children ">High temperature (fever) in children</a></li>

</ul>

<p>All of the above information is in the <a href="/library/manageLibrary.action">Library section</a></p>

<h2>What is an abnormal respiratory (breathing) rate for my child? </h2>

<p>Respiratory Rate more than 50 breaths per minute, if aged 6-12 months</p>

<p>Respiratory Rate more than 40 breaths per minute, if older than 12 months</p>

<h2>How do I take my child's respiratory rate? </h2>

<p>To count the number of breaths, or respirations, your child is taking per minute, observe your child's chest rise and fall or place your hand on your child's tummy and feel the rise and fall. One rise and a fall is one breath.</p>

<p>Count the number of times you see the chest rise and fall or the number of times the tummy rises and falls in 30 seconds and multiply by 2.</p>

<p>Normal respiration rates (breaths per minute) for children who are resting. <i>Breathing may be faster during exercise or crying and slower while asleep</i>.</p>

<h3>Normal Resting Respiration Rates</h3>

<table>

<thead>

<tr>

<th>Age</th>

<th>Breaths per minute</th>

</tr>

</thead>

<tbody>

<tr>

<td>Premature</td>

<td>40 - 70</td>

</tr>

<tr>

<td>0 - 3 months</td>

<td>35 - 55</td>

</tr>

<tr>

<td>3 - 6 months</td>

<td>30 - 45</td>

</tr>

<tr>

<td>6 - 12 months</td>

<td>25 - 40</td>

</tr>

<tr>

<td>1 - 3 years</td>

<td>20 - 30</td>

</tr>

<tr>

<td>3 - 6 years</td>

<td>20 - 25</td>

</tr>

<tr>

<td>6 - 12 years</td>

<td>14 - 22</td>

</tr>

<tr>

<td>13 years and older</td>

<td>12 - 18</td>

</tr>

</tbody>

</table>

<p>Above information taken from - <a href="https://northlondonpaediatrician.co.uk/wp-content/uploads/2014/07/NLP-heart-and-resp-rates.pdf">North London Paediatrician </a></p>

<h2>Symptoms and measurements</h2>

<p>You can track any symptoms related to RSV and take the child's temperature and respiration rate regularly, in this care plan to help you monitor your child.</p>

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