Ped's Respiratory/Asthma/Croup

Question 1

Initial Considerations/Differential Diagnosis

Answer 1

• Asthma
• Anaphylaxis
• Aspiration/inhaled foreign body
• Croup
• Pneumonia
• Pulmonary embolus
• Hyperventilation
• Inhaled toxin (i.e. carbon monoxide)

Question 2

Initial Actions

Answer 2

• Position of Comfort
• Administer O2 & Titrate to SaO2 of >94%

Question 3

If:
- Wheezing on lung
examination
- HX of Asthma/COPD

Answer 3

• Provide Nebulized Breathing TX
• IV Access if Possible
• Provide Solumedrol 2mg/kg IV/IM
• ETCO2 if Indicated

Question 4

If No Improvement or Severe Respiratory Distress

Answer 4

• Repeat Albuterol Dose
• Magnesium Drip 25mg/kg (2g MAX)
• 1:1 Epi 0.01mg/kg (0.3mg MAX) IM
• ETCO2
• Transport

Question 5

S/S of Croup & TX

Answer 5

<5 yrs (16 mnths - 3 yrs)
- Stridor
- Barking Seal Cough
- Hoarseness
- Low Grade Fever
- Difficulty Breathing
- Runny Nose/Sneezing

TX:
- Keep Calm (Avoid IV)
- Nebulized Epi 3mL of 1:1

Question 6

If No Improvement or Severe Respiratory Distress (Croup)

Answer 6

• Administer Solumedrol 2mg/kg IV/IM
• 1:1 Epi 0.01mg/kg (0.3mg MAX) IM
• ETCO2
• Transport