Croup and SGA

Question 1

What are the indications for the croup m.d.

Answer 1

Current history of URTI
AND
Barking cough or recent history of a barking cough

Question 2

What drugs can you administer under the croup m.d.

Answer 2

Epi and dexamethasone

Question 3

What are the conditions for the administration of EPINEPHRINE under the croup m.d.

Answer 3

Pt ≥ 6 months to < 8 years
HR < 200 bpm
Stridor at rest

Question 4

What are the conditions for the administration of DEXAMETHASONE under the croup m.d.

Answer 4

• Pt ≥ 6 months to < 8 years
• LOA unaltered
• For mild moderate and severe croup

Question 5

What are the contraindications for EPINEPRHINE and DEXAMETHASONE under the croup m.d.

Answer 5

EPINEPRHINE: allergy or sensitivity
DEXAMETHASONE:
- allergy or sensitivity
- Steroids received withing the last 48 hours
- Unable to tolerate oral medications

Question 6

Under the croup m.d. what is the treatment for EPINEPRHINE for a Pt <10 kg

Answer 6

Route: NEB
Dose: 2.5mg
Max single dose: 2.5 mg
Dosing interval: N/A
Max # of doses: 1

Question 7

Under the croup m.d. what is the treatment for EPINEPRHINE for a Pt ≥10 kg

Answer 7

Route: NEB
Dose: 5 mg
Max single dose: 5 mg
Dosing interval: N/A
Max # of doses: 1

Question 8

Under the croup m.d. what is the treatment for DEXAMETHASONE

Answer 8

Route: PO
Dose: 0.5 mg/kg
Max single dose: 8 mg
Dosing interval: N/A
Max # of doses: 1

Question 9

What are the indications for the use of the SGA m.d.

Answer 9

Need for ventilatory assistance or airway control
AND
Other airway management is ineffective

Question 10

What are the conditions to the use of SGA under the SGA m.d.

Answer 10

Absent gag reflex

Question 11

What are the contraindications to the use of SGA (under SGA m.d.)

Answer 11

1. Airway obstructed by a foreign object
2. Known esophageal disease (varices)
3. Trauma to the oropharynx
4. Caustic ingestion

Question 12

How many attempts do you have to insert an SGA

Answer 12

2 (per patient)

Question 13

What are the primary and secondary methods to confirm SGA placement

Answer 13

Primary; ETCO2 (waveform capnography)
Secondary: ETCO2 (non-waveform), auscultation, chest rise

Question 14

How do we identify an URTI?

Answer 14

• Fever
• Sore throat
• Difficulty speaking/swallowing
• Crying
• Not feeding

Question 15

What kidn of drug is dexamethasone

Answer 15

Adrenocortical steroid that binds to glucocorticoid receptors.
Promotes anti-inflammatory signals

Question 16

Give 5 exmaples of corticosteroids?

Answer 16

1. Hydrocortisone
2. Cortisone
3. Betamethasone
4. Budesonide
5. Beclomethasone
6. Dexamethasone

Question 17

How can you tell if airway management is ineffective?

Answer 17

• Vitals don’t improve
• No chest rise
• Poor air entry (auscultation)

Question 18

What does caustic ingestion mean?

Answer 18

ingestion of a chemical that burns/corrodes tissue

Question 19

True or False? and why?
You should consider witholding the SGA if the patient is actively vomiting?

Answer 19

True. It increases their risk of aspiration.