acutely ill child - respiratory Flashcards
what is bronchiolitis
acute viral inflammatory injury of the bronchioles
most common cause of bronchiolitis
RSV
who gets bronchiolitis
children under one, most common in children under 6 months
symptoms of bronchiolitis
viral URTI infection
dyspnoea, tachypnoea, apnoea
poor feeding
mild fever (<39)
clinical signs of bronchiolitis
respiratory distress
wheeze and crackles on auscultation
management of bronchiolitis
supportive
what is croup
URTI causing oedema in the larynx
what classically causes croup
parainfluenza virus
name 3 other common causes of croup
influenza
adenovirus
RSV
classic sign of croup
barking cough
management of mild croup
usually self limiting but could benefit a single dose of dexamethasone orally
management of croup that requires hospital admission
- Oraldexamethasone - if too unwell to receive oral medication can give IM dexamethasone or nebulised budesonide
- Oxygen
- Nebulised adrenaline
- Intubation and ventilation
symptoms of acute asthma
progressively worsening SOB
tachypnoea
clinical signs of acute asthma
respiratory distress
expiratory wheeze
chest sounds tight with reduced air entry
severity of acute asthma in terms of peak flow
moderate >50% of expected
severe <50% of expected
life threatening <33% of expected
management of mild acute asthma
regular salbutamol via a spacer
management of moderate-severe acute asthma
OSHITMA
what does OSHITMA stand for
oxygen
salbutamol (neb)
oral prednisolone/ IV hydrocortisone
ipratropium (neb)
theophylline
magnesium sulphate
an anaesthetist to intubate
what is the most common cause of bacterial pneumonia
strep pneumo
what is the most common cause of viral pneumonia
RSV
symptoms of pneumonia
wet/productive cough
high fever
increased work of breathing
lethargy
delirium
clinical signs of pneumonia
bronchial breath sounds
focal coarse crackles
dullness to percussion
what causes bronchial breath sounds in pneumonia
consolidation of the lung tissue around the airway
what causes coarse crackles in pneumonia
air passing through sputum
what causes dullness to percussion in pneumonia
lung tissue collapse and/or consolidation
investigations in pneumonia
CXR and blood cultures
first line management of pneumonia
amoxicillin
management of pneumonia in a patient with a penicillin allergy
erythromycin
