Laryngitis_Flashcards
What should be done if there is airway compromise in a patient with laryngitis?
Secure the airway; an emergency tracheostomy may be required.
What medication can be given to reduce oedema in laryngitis without diphtheria?
Dexamethasone sodium phosphate can be given to reduce oedema.
What antibiotics are administered for laryngitis without diphtheria?
Cefazolin and cephalexin are administered IV initially, then changed to oral antibiotics.
What is the treatment for laryngitis with diphtheria?
The patient needs to be isolated, given benzylpenicillin sodium IV/IM for 14 days, and diphtheria antitoxin.
What should be done if there is no airway compromise and laryngitis is viral?
For viral laryngitis: Provide analgesia as required (paracetamol), ensure vocal hygiene (voice rest for 3-7 days, increase hydration, humidification, decreased caffeine intake), and give a mucolytic to help lubricate the vocal folds.
What should be done if there is no airway compromise and laryngitis is bacterial?
For bacterial laryngitis: Provide phenoxymethylpenicillin for 14 days, analgesia as required (paracetamol), ensure vocal hygiene (voice rest for 3-7 days, increase hydration, humidification, decreased caffeine intake), and give a mucolytic to help lubricate the vocal folds.
What should be done if the patient has mild laryngomalacia?
Observation and reassurance that the condition will resolve by 12-16 months, manage gastro-oesophageal reflux with thickened feeds, famotidine or omeprazole, and Nissen fundoplication if necessary. The child should be fed upright.
What is the treatment for moderate and severe laryngomalacia?
Observation for increased work of breathing, manage gastro-oesophageal reflux, and consider elective surgery to improve symptoms and support development. In severe cases, endoscopic supraglottoplasty or tracheostomy may be needed, and BiPAP for obstructive sleep apnea.
What should be done for life-threatening laryngomalacia?
Keep the child calm, involve senior paediatricians/anaesthetics/ENT early, ensure they are in a safe environment (resus/HDU). Provide humidified oxygen, nebulised adrenaline, oral or IV dexamethasone, and heliox. If failing to maintain own airway, provide ventilatory support (Bag and Mask, nasopharyngeal airway, laryngeal mask, ETT) and surgical intervention if necessary.
What is the key sign on examination for laryngomalacia?
A high-pitched inspiratory stridor worse on lying flat or on exertion.
summarise laryngitis
Laz summary of laryngitis
