APPROACH TO BREATHING

Question 1

Approach to the Critically Ill Respiratory Distress

Answer 1

AIRWAY/BREATHING
Many children will respond to high-flow oxygen by nasal cannula in lieu of intubation.
Have smaller endotracheal tubes available because of the potential for a narrowed airway.
Medications
CIRCULATION
95% of all cardiac arrests in children have a respiratory etiology.
IV fluids at a bolus dose of 20 mL/kg should be administered and repeated to the goal of adequate perfusion, hemodynamic stability, and improved mental status.
Blood pressure may be normal in children, even those in shock.
Septic shock from viral etiology is far less common, but possible.

Question 2

DDx

Answer 2

Anaphylaxis
Angioedema

Bacterial Tracheitis
Diphtheria
Epiglottitis
Lemierre Syndrome
Ludwig Angina
Mononucleiosis
Peritonsillar Abscess
Retropharyngeal Abscess
Uvulitis

Bronchiolitis
Pneumonia
Asthma

CHF
Myocarditis
Malignancy

Question 3

DDx: Wheezing

Answer 3

Asthma (>2)
Bronchiolitis (<2)
GERD (with feedings)
FBA
CHF

Question 4

DDx: Stridor and Drooling

Answer 4

Anaphylaxis
Angioedema

Foreign body
Croup
Epiglotittis
Retropharyngeal / Peritonsilar abscess
Bascterial Tracheitis