Heliox-Driven Racemic Epinephrine in Treatment of Bronchiolitis in Pediatric ED Patients

Inclusion Criteria: * Any child 2-12 months old seen in the emergency department. * A clinical bronchiolitis score \> 3 by modified Wood's Clinical Bronchiolitis Score (M-WCBS). * Diagnostic criteria of bronchiolitis includes tachypnea, cough, prolonged expiratory phase, wheezing, rales, chest retractions, and hyperinflation of lungs on chest radiograph. After consenting a patient to the study, respiratory syncytial virus (RSV) infection will be tested by rapid enzyme-linked immunoabsorbent assay of nasal secretions. Exclusion Criteria: * No child will be excluded based on race or gender * Patients under the age of 2 months or greater than 12 months * Patients with cyanotic heart disease * Patients with lobar pneumonia, defined by results of chest radiographs. * The presence of interstitial disease or diffuse patchy marking consistent with atelectasis on chest radiographs will not exclude patients. * Patients with croup. * Patients with foreign body aspiration. * Patients with history of cystic fibrosis, bronchopulmonary dysplasia or other chronic lung disease. * Patients with liver or renal disease. * Patients with sickle cell anemia. * Patients requiring mechanical ventilation. * Patients who develop supraventricular tachycardia secondary to racemic epinephrine administration. * Patients with tracheomalacia or bronchomalacia. * Patients who had received bronchodilators within 2 hours of initiation of the study. * Patients who had received systemic corticosteroids within 72 hours of enrollment * Patients who suffered from persistent airway hyperreactivity in the 3 months before the study. * Patients who do not tolerate the nasal cannulae for 45 out of 60 minutes.