Paeds resp conditions Flashcards
In a child with croup. While awaitinghospitaladmission what would you give the child? (2 things)
- Supplementary oxygen
- Administer a dose of oral dexamethasone (0.15 mg/kg)
Note:
If the child is too unwell to receive medication, inhaled budesonide (2 mg nebulised as a single dose) or intramuscular dexamethasone (0.6 mg/kg as a single dose)are possible alternatives.
What features suggest severe Croup? (3 things)
- Seal-like barking cough
- Stridor and sternal intercostal recession
- Agitation and lethargy
What features suggest moderate croup? (3 things)
- Seal like barking cough
- Stridor and sternal recession at rest
- No agitation or lethargy
What features suggest mild croup? (2 things)
- Seal-like barking cough
2. No stridor or sternal/intercostal recession at rest
What are the risk factors for Croup? (3 things)
- previous intubation
- 6months- 6 years (2 year olds specifically)
- Male
What is Croup?
Inflammation of the upper respiratory tract as a result of a viral infection (typically parainfluenza virus types 1 or 3)
How might a child present with CF?
If it is not picked up on new born screening (heel prick test) then :
- Meconium ileum (@aged 2 weeks) – obstruction of first poo
- Respiratory symptoms
- Failure to thrive (failure to gain weight by 14 months)
What is bronchiolitis ?
A common resp infection in children. It is characterised by inflammation of the small airways called the bronchioles in the lungs. And It is often caused by a viral infection (RSV virus)
In croup what x-ray findings might you see?
and what x-ray findings might you see on acute epiglottitis?
CROUP
Steeple sign
ACUTE EPIGLOTTIS
thumb sign
What is acute epiglottis? and how might a child present?
Swelling of the epiglottis caused by bacterial infection. commonly haemophillis influenza type B.
The might present with:
- Drooling
- Tripod sign
- Muffled voice
- Scared and quiet
- high fever
- Painful swallowing
How would you manage acute epiglottis ?
- DONT DISTRESS THE CHILD - keep them on their parents lap DONT examine the throat as this may lead to laryngospasm and airway closure
- alert paediatrics and anaesthetist ASAP
- If the child is in respiratory arrest (stops breathing or isn’t breathing properly)
whilst awaiting an ambulance–> Nebulised adrenaline + IV ceftriaxone + dexamethasone)
What is the RSV virus and how is it treated ?
This is a common virus that causes LRTI in children <1 years old. Symptoms usually peak in 3-5 days but are resolved by day 10.
symptoms include that of bronchiolitis
What is pertussis (whooping cough) also known as the 100 day cough.
A highly infectious disease caused by the virus bordetella pertussis. Common in children. characterised by a cyclical ‘whooping cough’
What are the symptoms of pertussis ?
explain the 3 phases
Phase 1:
Catarrhal phase
- 1-2 weeks
- similar sx to that of an upper airway infection
(low grade fever, conjunctivitis, malaise, nasal discharge, dry unproductive cough)
Paroxysmal phase:
- 1 week after catarrhal phase
- coughing fits
- lasts 1-6 weeks
- often at night
- thick mucus
- no chest signs
Convalescent phase:
- lasts up to 3 months
- gradual improvement in cough frequency and severity
How would you manage pertussis ?
- If acutely unwell & <6 months then admit
- if no admission then ABX
WITHIN FIRST 21 DAYS!
- 1st line: clarythromycin (if <1 month old)
- azithromycin (if 1 month or older + non pregnant adults)
- conservative advice
- rest
- fluids
- Calpol
- advise the cough will take several weeks to clear
- SAFETYNET!
- vaccinate if not already done (when recovered!) - find out who the child has been in contact with and advise on prophylaxis abx. (only if the other children are unvaccinated, pregnant women, shared household, institution)
