Help me understand wheezing in toddler (RSV and Bronchiolitis)

[StoriesInTheSoil]

We don't typically do to the doctor in our house but yesterday, my son who has had a cold for about 2 weeks was wheezing loudly in his sleep. I called the doctor and brought him in later in the day and the wheezing had gotten progressively worse through the day. He is still wheezing badly and is now on albuterol every 4 hours (he's had 5 treatments thus far) He was diagnosed with Brochiolitis and I was told that he probably had RSV.

This is new to me so I have a few questions.

1) Are there any downsides to the albuterol? Are there alternatives? Negative side effects? How do I know it's working?

2) I've read that there can be long-term implications of wheezing in toddlerhood (chronic asthma, etc) can anyone explain this to me?

3) What should I be watching for right now (how will I know if he's getting worse or getting better?)

We aren't getting much sleep and the cough/wheezing are worrisome to me to my research capacity is diminished- if anyone can give me any information, it would be much appreciated.

TIA!

[SunshineJ]

Albuterol can cause the jitters for about an hour after administration. I assume you're using a nebulizer? One thing our dr told us was that you don't have to put the mask actually on the child, but direct it up from the chin (some kids really freak out over the mask). If he has RSV you'll be able to tell by watching his chest when he breathes - it does this weird sucking in thing with it. Honestly I'm not trying to scare you but RSV can turn into some nasty stuff. If he's not better in 48 hrs or gets worse after 12 I'd take him in to the ER. I'm not a huge fan of medical intervention, but that's one I won't mess with after seeing too many kids admitted for it. However, keep in mind too that without a test or the obvious breathing thing, there's no way to know for sure he even has it, so don't panic about it, just keep an eye on him (not that you wouldn't already!).

[StoriesInTheSoil]

He does the nebulizer without much of a fight (we let him watch pink panther clips if he leaves the mask on) but his cough and wheezing still sound awful. The cough is so loud! What should I do?

[mbbinsc]

Is he responding to treatment or just getting worse. I agree with seeking further medical care if not improving. You can count his respiration for a minute and call MD on call for advice. I'd tell them how he is responding to the treatment along with rate and any other things you notice. My DD did not have RSV but viral asthma. When she first had it we went to MD 2 days in a row and left with the advice that if things got worse to go to ER. Luckily, she turned a corner. FWIW, we used Xopenex in nebulizer as there are less side effects.