Random Resp

Question 1

What should you do if a child is choking?

Answer 1

Assess the severity then call for help. If there is an effective cough then encourage coughing and continue to check for deterioration.

If the cough is ineffective then give 5 back blows followed by 5 thrusts (chest for infant and abdominal for >1 year) if conscious.

If unconscious then openairway, give 5 breaths and start CPR.

Question 2

What happens when someone inhales a large amount of smoke?

Answer 2

• The alveoli, and other parts of the respiratory tract, become coated inparticulates which impair gas exchange and reduce the amount of oxygen getting into the body
• Smoke can also be incredibly hot and inhalation burns are common to the very upper respiratory tract
• These burns around the airway can lead to swelling and occlusion of the airway further down the line.
• Finally smoke can contain many nasty chemicals such as carbon monoxide or toxic fumes which can cause a desaturation of haemoglobin and loss of consciousness.

Question 3

What are symptoms of smoke inhalation?

Answer 3

• Cough
• SOB
• Sore throat
• Headache
• Confusion
• There can also be a lot of mucosal oedema caused by the burning of the mouth and throat
• The patient may be blue or cyanosed as asphyxia sets in due to the deposition of smoke in the lower lungs
• Respiratory rate will also increase accordingly.

Question 4

How should you manage a patient with smoke inhalation?

Answer 4

• The patient should be taken to safety and placed in fresh air before being given high flow and humidified oxygen to breathe
• 100% oxygen helps to remove CO from the blood quickly and reduces any poisoning affect that it may have had
• CO is the leading cause of cardiac arrest and death before patients reach hospital
• About 50% of patients will need intubation and PEEP to maintain the airway.

Question 5

What is a vascular ring?

Answer 5

It is a congenital abnormality in which the aorta forms a double arch which forms a ring around the trachea and oesophagus. This can cause problems with breathing and rarely digestive symptoms. Note may be asymptomatic

Question 6

How may a vascular ring present?

Answer 6

Respiratory distress High-pitched cough Stridor Repeated LRTI Wheezing

Question 7

What is Congenital Cystic Adenomatoid Malformation?

Answer 7

It is a rare abnormality of lung growth in which there is adenomatous overgrowth of the terminal bronchioles with subsequent reduction in alveolar growth.

Question 8

How may a congenital cystic adenomatoid malformation (CCAM) present?

Answer 8

Often picked up in antenatal USS screening. Presents with respiratory distress in the newborn (ranging from grunting to fulminant respiratory failure) May develop spontaneous pneumothorces Also causes recurrent respiratory infection.

Question 9

What are some of the associations of CCAM?

Answer 9

Polyhydraminos Fetal hydrops Renal Abnormalities

Question 10

What is primary ciliary dyskinesia?

Answer 10

It is an autosomal recessive condition characterised by: -Neonatal respiratory distress -Chronic rhinorrhoea -Recurrent infection causing bronchiectasis -Male infertility As well as Situs invertus (organs on opposite side) It is also called Kartagener’s syndrome Also associated with conductive deafness.

Question 11

What is bronchiolitis obliterans?

Answer 11

An extended version of bronchiolitis which can last for several months and results in fibrosis of the lung tissue and permanent damage. Commonly caused by adenovirus.

Question 12

What is idiopathic juvenile dermatomyositis and what are the classical symptoms?

Answer 12

It is an idiopathic inflammatory myopathy Classical symptoms: -Red heliotrope rash affecting the face, eyelids, hands, and sometimes the skin above joints. -Muscle weakness

Question 13

What is tracheobronchomalacia?

Answer 13

Tracheobronchomalacia (TBM) is a rare condition that occurs when the walls of the airway (specifically the trachea and bronchi) are weak.

Question 14

How does tracheobronchomalacia present?

Answer 14

Can cause: SOB Cough Wheeze Stridor Sputum retention Persistent wheeze which worsens after administration of bronchodilators. (bronchodilators further relaxes the muscle)

Question 15

What is SCID?

Answer 15

Severe combined immunodeficiency. It is an x linked recessive disorder in which there is a deficiency in B and T cells causing there to be recurrent infections. Note: other forms of inheritance but X linked is the most common