RSV- swab v/s wash

[RhiaRN75, RN]

What do you think gives an accurate result on RSV tests... nasal washes or swabs? I personally feel washes are better, but it's how I learned to do them on peds. A wash does take a little longer to prepare for and you have to be careful to position the child correctly to prevent aspiration. Plus it usually upsets the parents and ticks off baby. On the other hand, it's harder for me to keep a baby still enough to feel I can safely obtain a good swab- I worry that if the baby moves at the wrong point it can wind up with a nosebleed, which upsets the parents and hurts baby. (Even with good help to hold them still- babies are good at squirming!) Since RSV seems to cause alot of nasal secretions, I've been considering an alternative. Almost all babies cry after the doc examines them, basically creating a 'natural' nasal wash- what if I just bulb suction them afterwards and squirt the contents into a sterile container, swirl the swab around and drop it in, and then take the whole thing to the lab?? It's basically the same principle as a nasal wash w/ saline, or am I overlooking something?

Any ideas?

[Marrn]

We usually obtain RSV specimens with a nasal wash, but occasionally if there's copious nasal discharge, a bulb syringe will work just fine. We haven't used swabs.

[MERRYWIDOW46]

Our protocol is nasal wash.

[PAERRN20]

We can't do nasal swabs- must be washings.