1 - Paeds - Resp - DDx Upper Airway Obstruction

Question 1

what could it be?

Answer 1

croup
epiglottitis
inhaled FB
trauma
smoke inhalation
bact tracheitis
congenital

Question 2

clinical thought process - inhaled foreign body (effective cough)

Answer 2

assess severity > effective cough? > encourage cough, check for deterioration

Question 3

clinical thought process - inhaled foreign body (ineffective cough)

Answer 3

assess severity > ineffective cough? > conscious? (5 back blows, 5 thrusts - infant: chest, child >1: abdo)
unconscious? - open airway, 5 breaths, start CPR

Question 4

bact tracheitis - other name? rare but?

Answer 4

rare but dangerous

pseudomembranous croup

Question 5

bact tracheitis - similar to? but different how?

Answer 5

similar to severe viral croup but child has high fever, appears toxic, and has rapidly progressive airway obstruction without copious thick secretions

Question 6

bact tracheitis - cause? treatment?

Answer 6

s aureus

IV ABx, intubation and ventilation if required

Question 7

smoke inhalation ->

Answer 7

resp defences overcome, coughing ineffective, gas exchange surfaces coated in particles, impairing gas exchange

Question 8

heat of smoke ->

Answer 8

burns to airway, > swelling, occlusion

Question 9

chemicals in smoke eg CO ->

Answer 9

desaturation of Hb and Loss of consciousness

Question 10

clinical features of smoke inhalation

Answer 10

cough, sob, sore throat, headache, confusion

mucosal oedema due to throat burns

RR increased

blue/cyanosed - from asphyxia due to smoke in lower lungs

Question 11

mgmt of smoke inhalation

Answer 11

fresh air
high flow humidified O2
100% O2 helps remove CO from blood

Question 12

smoke inhalation - 50% need what? CO - leading cause of?

Answer 12

leading cause of cardiac arrest/death pre hospital

50% need intubation and PEEP to maintain airway