Airway Obstruction Flashcards
Most common age group for croup
6 to 24 months
Most common organisms causing croup
Viral:Para influenza virus
Less common: measles
HIV positive: herpes simplex , candida albicans oesophagus
Klein classification: croup
Grade 1: inspiratory Stridor – observe
grade 2: inspiratory and expiratory Stridor – Nebulised adrenaline
Grade 3: as above plus pulsus paradoxus – continuous nebulised adrenaline if no improvement Intubate
Grade 4: impending apnoea – Intubate
Clinical picture of croup
Non-specific up the respiratory infection followed by barking cough and Stridor
Chest x-ray sign of croup
Church steeple sign: narrowing of the upper end of the trachea
When I steroids contraindicated in croup
Croup caused by measles or herpes simplex
Most common cause of acute bacterial epiglottitis
H influenza B
Clinical picture of epiglottitis
Swollen upper airway: Cherry red Stridor : less prominent then croup Difficulty swallowing: drooling Tripod position Systemically ill
Special investigations for epiglottitis
None prior to Intubation may precipitate airway obstruction
Chest x-ray sign of epiglottitis
Hitchhikers thumb sign
Management of epiglottitis
Intubation regardless of degree or obstruction: extubate in 24 to 48 hours
STAT dose of: ampicillin/cefriaxone + corticosteroids
Clinical signs: extrathoracic versus intrathoracic airway obstruction
Extrathoracic: Stridor Inspiratory Recession marked Tachypnoea moderate Diminished airentry Chest x-ray normal
Intrathoracic: Wheeze expiratory Resection less marked barrel chest Tachypnoea marked Chest x-ray: emphysema
