Paediatric respiratory Flashcards
What are the risk factors for croup?
Age 1-3
Winter, autumn
What is the aetiology of croup?
Usually parainfluenza virus 1 or 3
Can be influenza A, B, adenovirus, RSV, measles (rare)
What is the pathophysiology of croup?
Oedema of the airways, necrosis and shedding of the epithelium
Narrowed subglottic region causing seal-like barking cough, stridor and intercostal indrawing
What are the symptoms and signs of croup?
Abrupt onset, worse at night and with agitation symptoms Barking seal cough Hoarse voice SOB Stridor Increased work of breathing
Which parameters are useful in assessing severity of croup?
Behaviour/mental state Stridor Respiratory rate Accessory muscle use Oxygen saturation
What are the signs of mild croup?
Normal behaviour
No stridor at rest
Normal RR
Mild chest wall retractions
What are the signs of moderate croup?
Mild, intermittent agitation
Intermittent stridor at rest
Increased RR
Moderate chest wall retractions
What are the signs of severe croup?
Increased agitation or drowsiness Persistent stridor Increased or decreased respiratory rate Marked chest wall retractions Hypoxia - sign of life-threatening croup
Which investigations are performed for croup?
None
Outline the management for croup
- Supportive Mx and education
- Oral or nebulised steroids
- Nebulised adrenaline if severe
- If life-threatening or poor response
What are the steroid options for croup?
Dexamethasone oral, IM, IV
Prednisolone oral
Budesonide inhaled
What is the management for life-threatening croup?
Senior help, anaesthetist and ICU involvement
Nebulised adrenaline
Systemic steroids
Oxygen 15L/min
What is the prognosis for croup?
Resolve within 3-4 days, no major risk of long-term complications
