Paeds Resp Flashcards
What is a general description of Croup?
Inflammation of the larynx, trachea, & proximal bronchi
At what age is Croup likely to occur?
6months to 6years
What is the aetiology of Croup?
Viral:
Parainfluenza (Buzz)
RSV (most common)
Influenza
What are the risk factors for Croup?
Winter Low SES Poor nutrition Immunosuppression Household smoking in 1st year of life
What are risk factors for SEVERE Croup?
Existing tracheal narrowing
Previous admission with croup
Younger age
What are the symptoms of croup
Prodromal URTI Barking cough (seal cough) Inspiratory stridor Hoarseness Worse at night
SEVERE:
Agitation / drowsiness
Increased WOB
Hypoxia
What is the management of Croup?
Minimal handling - keep with handlers
Do not change position of comfort
Ensure hydration
Manage symptoms:
If mild- Dexamethasone or prednisolone 0.15mg/kg
If severe - add nebulised adrenaline and oxygen if needed (non-rebreather)
Discharge when stridor free
Return if stridor returns
What is a general description of Bronchiolitis?
Self-limiting viral infection of the lower respiratory tract, usually caused by RSV
At what age is bronchiolitis most common?
Less than 12 months.
Less than 6 months for those requiring hospitalisation
What is the aetiology of bronchiolitis?
Sloughing of infected nasal mucosa into bronchioles, leading to bronchiolar infection, atelectasis, and gas trapping
What are the risk factors for bronchiolitis?
Winter
Household smoking
What are risk factors for SEVERE bronchiolitis?
Immunodeficiency Down's Corrected age <10weeks(low maternal Ig) CLD CHD ATSI
What are the symptoms of bronchiolitis?
Cough Tachypnoea Widespread wheeze and crackles Fever Episodic apnoea and desaturation hyperinflation
SEVERE: Agitation / drowsiness Increased WOB Sats <90% Persistent apnoea Reduced feeding
What is the natural history of bronchiolitis?
Worsens up to day three
Resolves by day 7-10
What is the prophylactic treatment for bronchiolitis in high risk pre-term infants?
Palivizumab (IgG)
