Comparing Nasal Suction Devices in Children With Bronchiolitis: A Pilot Study

• Percentage of (NoseFrida) patients discharged home before the current mean length of stay of 25.7 hours. [ Time Frame: Participants will be followed for the duration of their stay in the EDOU, an expected mean length of stay of 25.7 hours. ]
  The study group will analyze the length of stay for the NoseFrida group and compare it with the current mean length of stay (which included the use of the NeoSucker) of 25.7 hours.
  
  

• Number of participants with serious and non-serious adverse events [ Time Frame: Participants will be followed for the duration of their stay in the EDOU, an expected mean length of stay of 25.7 hours. ]
  The study group will be looking at the use/type of suction device and any clinically significant findings that might be caused from the suction device (NoseFrida/NeoSucker), such as bleeding.
  
  

• Percentage of patients readmitted within 48 hours of discharge. [ Time Frame: within 48 hours of discharge ]
  The study group will analyze those patients both from the NoseFrida group and the NeoSucker group who are readmitted within 48 hours of discharge from the EDOU.
  
  
• Parental satisfaction (NoseFrida group) will be measured using a newly developed survey tool (Likert scale). [ Time Frame: Participants will be followed for the duration of their stay in the EDOU, an expected mean length of stay of 25.7 hours. ]
  A study specific survey was developed to measure parental satisfaction of the NoseFrida device. The survey is designed to capture parental satisfaction on a 5 point Likert scale.
  
  

Bronchiolitis is a viral illness and a common cause for admission to the hospital. Most patients with bronchiolitis are managed at home. The indications of hospitalization are poor feeding (due to increased mucus production) and respiratory distress with and without hypoxia. The EDOU is a common destination of patients with bronchiolitis. Patients are admitted to the EDOU for respiratory monitoring, suctioning and poor oral intake. The management of bronchiolitis is mostly supportive which includes frequent feedings, nasal suctioning, intravenous fluids and oxygen if necessary. The patients admitted to the EDOU receive frequent nasal suctioning by a suction device (NeoSucker) and deep suctioning as needed. Since young infants are "nose breathers," the use of nasal suctioning helps to relieve nasal congestion/upper airway obstruction and assists with their ability to breathe and feed. Suctioning can be accomplished by the use of the bulb suction, nasal aspirators and/or suction catheters connected to pressure devices.

The role of the type of suctioning device in the management of bronchiolitis has not been studied extensively. In our study, a nasal aspirator (developed in Sweden by an Ear, Nose and Throat specialist) by the brand name of NoseFrida will be compared to the NeoSucker, a suction catheter currently used in our hospital setting which requires both a nurse and a pressure device. Nasal suctioning is less traumatic and does not cause the discomfort, bleeding and rebound swelling that deep suctioning can. Upon admission, patients will be randomized to either the NoseFrida or NeoSucker group. After consent is obtained for agreed participation, the patients parents randomized to the NoseFrida group will be given a NoseFrida/filters and instructions on usage (instructional video/postcard). The parents will be encouraged to use the NoseFrida suction device as often as they want, especially before feeds and sleep. The patients randomized to the NeoSucker group will be given the current standard of care and nasal suctioned by a nurse. Both groups will be deep suctioned as clinically needed.