Management aspects of UPPER RESPIRATORY TRACT INFECTIONS Flashcards
DO UPPER RESPIRATORY TRACT INFECTIONS SELF-RESSOLVE?
USUALLY YES
ADVICE FOR PARENTS OF CHILDREN WITH UPPER RESPIRATORY TRACT INFECTIONS CONSISTS OF?
-REST
- EXTRA FLUIDS
- ANALGESICS
-ANTIPYRETICS
- ESTIMATE OF LIKELY DURATION.
WHAT ABOUT AXBS ?
MOST UPPER RESPIRATORY TRACT INFECTIONS ARE VIRAL AND WILL SELF RESOLVE SO AXB ARE NOT USUALLY PRESCRIBED.
WHAT ABOUT BACTERIAL CAUSE IN UPPER RESPIRATORY TRACT INFECTIONS? AND AXB?
THERE IS BACTERIAL CAUSES OF UPPER RESPIRATORY TRACT INFECTIONS BUT THEY RARELY NEED AXBS.
DO AXBS HELP?
NO, THEY USUALLY DO NOT IMPROVE SYMPTOMS AND CAN HAVE SIDE EFFECTS.
GP’S ROLE WITH AXBS AND UPPER RESPIRATORY TRACT INFECTIONS.
TEND TO USE THREE AXB STAGES
WHAT ARE THE THREE AXB STAGES WITH GPS?
STAGE 1 :
NO AXBS ARE NEEDED WHERE THE UPPER RESPIRATORY TRACT INFECTION IS THOUGHT TO BE SELF-LIMITING (SELF-RESOLVES)
WHAT ARE THE THREE AXB STAGES WITH GPS?
STAGE 2:
DELAYED AXBS ARE USEFUL WHEN SYMPTOMS FAIL TO IMPROVE OR WORSEN.
WHAT ARE THE THREE AXB STAGES WITH GPS?
STAGE 3:
IMMEDIATE AXB PRESCRIPTIONS ARE RESERVED FOR THE MOST SEVERE CASES.
REFERRAL PATHWAY
HOSPITAL INTAKE MAY BE INDICATED WHEN?
DEMINISHED FLUID INTAKE
CONCERNS REGARDING DIAGNOSIS MAY PERSIST
CHILDREN WITH MUFFLED VOICES
TENDERNESS BEHIND THE EAR
RED FLAGS WITH UPPER RESPIRATORY TRACT INFECTIONS
<3 MONTHS WITH A FEVER >38
TOXIC APPEARANCE, SIGNS OF SEPSIS.
RESPIRATORY DISTRESS, STRIDOR, VOICE CHANGES, TRISMUS (LOCK JAW), DROOLING, TORTICOLLIS (STIFF NECK), NECK SWELLING, INADEQUATE ORAL HYDRATION.
SEVERE SUPPURATIVE COMPLICATIONS.
WHAT IS FeverPAIN?
SCALE USED TO HELP DETERMINE STREPTOCOCCUS.
WHAT TO NOTE ABOUT FeverPAIN??
ONLY VALIDATED IN CHILDREN >3 YEARS.
FeverPAIN? WHAT ARE YOUNGER CHILDREN LESS LIKELY TO DEVELOP? WHAT ABOUT COMPLICATIONS?
BACTERIAL AETIOLOGY AND ARE LESS LIKELY TO DEVELOP COMPLICATIONS.
FeverPAIN. WHAT ABOUT AXBS?
AXB IN THIS AGE GROUP IS BASED ON CLINICAL JUDGEMENT
FeverPAIN
is it a munomic and how does it go?
yes
FEVER - OVER 38
PURULENCE (PHARYNGEAL/TONSILLAR EXUDATE).
ATTEND RAPIDLY (3 DAYS OR LESS).
SEVERELY INFLAMED TONSILS
NO COUGH OR CORYZA
STREPTOCOCCUS - LIKELIHOOD OF IDENTIFYING THE CONDITION
0-1 score
0 to 1 score is associated with a 13% to 18% likelihood of isolating streptococcus
STREPTOCOCCUS - LIKELIHOOD OF IDENTIFYING THE CONDITION.
2 to 3
2 to 3 is associated with 34% to 40% likelihood of identifying streptococcus.
STREPTOCOCCUS - LIKELIHOOD OF IDENTIFYING THE CONDITION
4 to 5
4 to 5 is associated with a 62% to 65% likelihood if identifying streptococcus.
what is it centor criteria
set of clinical criteria used to help assess the likelihood of a bacterial infection, specifically group A Streptococcus (Streptococcus pyogenes), in patients presenting with a sore throat
How does the centor criteria work?
patient gets one point for each of the criteria they meet
with patients getting one point for each of the criteria, what is the criteria ? A-D
A- TONSILLAR EXUDATE (WHITE/YELLOW PUSS ON THE TONSILS).
B- TENDER ANTERIOR CERVICAL ln OR LYMPHADENITIS
C- HISTORY OF A FEVER
D- ABSENCE OF COUGH
CENTOR CRITERIA
SCORE CRITERIA FOR IDENTIFYING STREPTOCOCCUS.
0,1, OR 2
0, 1 OR 2 IS ASSOCIATED WITH A 3-17% LIKELIHOOD OF IDENTIFYING STREPTOCOCCUS.
CENTOR CRITERIA
SCORE CRITERIA FOR IDENTIFYING STREPTOCOCCUS.
3 OR 4 IS ASSOCIATED WITH 32-56% LIKELIHOOD OF IDENTIFYING STREPTOCOCCUS.
