4th year child health resp Flashcards
croup presentation?
-mild
-moderate
-severe
Barking cough, stridor, low grade fever
MILD:
* Occasional barking cough
* No audible stridor at rest
* No/ mild suprasternal and/or intercostal recession
* Child happy and prepared to eat, drink, play
MODERATE:
* Frequent barking cough
* Easily audible stridor at rest
* Suprasternal and sternal wall retraction at rest
* Little or no distress or agitation
* Child can be placated and is interested in its surroundings
SEVERE:
* Frequent barking cough
* Prominent stridor at rest
* Marked sternal wall retractions
* Significant distress and agitation, or lethargy or restlessness (sign of ypoxaemia)
* Tachycardia
* Exhaustion
Cyanosis
who gets admitted croup:?
NICE suggest admitting any child with:
* moderate or severe croup
* < 3 months of age
* known upper airway abnormalities (e.g. Laryngomalacia, Down’s syndrome)
uncertainty about diagnosis (important differentials include acute epiglottitis, bacterial tracheitis, peritonsillar abscess and foreign body inhalation)
investigations croup?
Most= diagnosed clinically
DO NOT EXAMINE THROAT- risk airway obstruction
CXRAY:
POSTERIOR ANTERIOR
Steeple sign- subglottic narrowing
LATERAL
Thumb print sign- swelling of the epiglottis
managment croup?
Responds well to treatment to DEXAMETHASONE
Mild-
1st= oral dexamethasone and do not need observed in ED
Moderate-
1st= Oral dexamethasone + observe in ED for 2 to 3 hours
If symptoms improve can go home
If symptoms worsen 2nd = nebulised adrenaline
Severe
* Oral/ IV dexamethasone
* Nebulised adrenaline
O2 by facemask
cause- croup?
Parainfluenza virsu
RSV
Diptheria (rare due to vaccination)
Influenzae
Adenovrius
what are high risk respiratory symptoms that require urgent admission of a child?
-Grunting
-Tachypnoea
-RR over 60 BPM
-Moderate or severe chest indrawing
<3 months temperature 38 or above
