Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Croup-Epiglottitis > Flashcards

Croup-Epiglottitis Flashcards

1
Q

What is the most important aspect of anesthesia care in the management in the difficult pediatric airway?

A
  • Preoxygenation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the primary differences in croup in relation to stridor?

A
  • Caused by turbulent flow
  • High-pitched adventitious sound
  • Biphasic (inspiratory and expiratory)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the three classifications of stridor?

A
  • Biphasic
  • Inspiratory
  • Expiratory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does biphasic stridor indicate?

A
  • Lesion of the larynx or subglottis

- CROUP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does inspiratory stridor indicate?

A
  • Laryngeal or subglottic obstruction
  • Laryngomalacia
  • Vocal cord paresis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does expiratory stridor indicate?

A
  • Intrathoracic process
  • Extrinsic tracheal compression
  • Tracheomalacia
  • Bronchotrachetis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the most common patient characteristics in Croup?

A
  • Haemophilus parainfluenzae infection of the upper respiratory tract (Types 1, 2, 3)
  • 1-3 years old, median age 18 months
  • 2:1 prevalence in males
  • S/S: (low fever, barking cough, hoarseness, dyspnea, exhaustion and hypoxia, self-limiting and benign, slow onset, rhinorrhea)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a typical feature seen in a CXR of the airway in the patient with croup?

A
  • Steeple sign (narrowing of subglottic airway)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the Westley Croup Score?

A
  • Mild croup <2
  • Moderate croup 3-7
  • Severe croup >8
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some important aspects of the medical management of Croup?

A
  • 02 and cool humidity
  • Racemic Epi (0.5 mL of 2.25% of 2.5 mL of NS) (avoid in children with glaucoma and ventricular outflow obstruction, aka Tetralogy of Fallot) REBOUND AIRWAY COMPROMISE AFTER EPI WEARS OFF
  • Hydration
  • Steroids (Symbicort, decadron)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Does Croup always require intubation?

A
  • NOT USUALLY, depends on airway constriction

- Dry-out patient in case of emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe post-extubation Croup

A
  • Occurs from inflammatory response created by extrinsic factors: ETT
  • Luminal narrowing
  • Poiseuille’s principle (16-fold increase in airway resistance with laminal narrowing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the primary risk for Post-extubation Croup?

A
  • CUFFED ETT UNDER PRESSURE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the treatment of post-extubation croup?

A
  • REDUCE AIRWAY CONSTRICTION
  • HELIUM AND GAS MIXTURE
  • REINTUBATION WITH 1/2 SIZE SMALLER
  • AVOID TOPICAL LIDOCAINE (VASODILATION)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When does epiglottitis occur?

A
  • ANY AGE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the usual cause of epiglottitis?

A
  • Inflammation is secondary to an infectious process, normally H. influenzae. Can be viral.
  • FAST ONSET OF SYMPTOMS
  • Salivation, anxious, cyanosis, high fever, drooling
17
Q

Describe the key features in the anesthetic management of the patient with epiglottitis

A
  • SITTING POSITION FOR PREOXYGENATION, DON’T LIE PATIENT DOWN
  • DIFFICULT AIRWAY EQUIPMENT AND CRICOTHYROIDOTOMY TRAY
  • INTUBATE IN OR IF ETT INDICATED
  • “THUMB SIGN” ON LATERAL CXR
  • ANTIBIOTICS BEFORE EVERYTHING ELSE, INCLUDING 02!!!!!
  • KETAMINE
  • RSI NOT ALWAYS INDICATED
  • AWAKE INTUBATION SHOULD BE AVOIDED
18
Q

What is the cause of cleft palate?

A
  • Defect in palatal growth
  • More common in males
  • Unilateral cleft lip, unilateral cleft lip, and palate, bilateral cleft lip, and palate, cleft palate alone
19
Q

Describe the features of cleft palate

A
  • More common in males
  • Usually left-sided
  • Large, cavernous defect
  • cleft lip at 3 months
  • Cleft palate at 6 months
  • Associated w/ many syndromes (Pierre Robin, Treacher Collins, Downs Syndrome, Fetal Alcohol Syndrome)
20
Q

What are the anesthesia considerations with a cleft palate patient?

A
  • PREPARE FOR DIFFICULT AIRWAY (HAVE LMA AVAILABLE)
  • INHALATION INDUCTION
  • SEVOFLURANE
  • 100% 02
  • Difficult mask ventilation may require adjunct airways
  • Oral RAE taped to chin
  • PLACEMENT OF NASAL AIRWAY TO ENSURE PATENT AIRWAY

Pediatrics (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions