Resp distress Flashcards
common causes of cough
- pneumonia
- asthma
- URTI
- Bronchioloitis
- whooping cough
- FB
- bronchiectasis
common causes of wheeze
- bronchiolitis
- asthma
- HF
- FB
common causes of acute stridor
- croup
- anapylaxis
- FB
- epiglottitis
common causes of chronic stridor
- laryngomalacia
- vocal cord palsy
- subglottic stenosis
until what age are infants nasal breathers
6-12mo
what are the differences in a kids airway
- smaller airways
- trachea more cartilagenous + soft
- narrowest point cricoid cartilage
what are some signs of increased WOB
- tachypnoea
- tachycardia
- nasal flaring
- grunting
- tripod
- paradoxical breathing
- head bobbing
- accessory muscles
what is a ddx for asthma in a child <3yrs
transient wheeze of infancy
what is croup
AKA laryngotracheobronchitis
viral infection of larynx, trachea and bronchitis
most common age for croup
6mo-5yrs
rare <3mo
common organism of croup
parainfluena
what is the typical course of croup
worse at night. peaks day 2/5
sx of croup
- wheeze widespread
- increased WOB
- barking cough
- coryzal sx
- insp stridor
mx of croup
mild-mod
prednisolone 1mg/kg for 2 nights
severe
neb adrenaline and Im/IV dexamethasone
what is epiglottitis
bacterial infection of epiglottis
age for epiglottitis
2-4yo
organisms of epiglottitis
H. influenza, S. aureus, strep. pneumonie
sx of epiglottitis
drooling febrile dysphagua leaning forward not coughing or speaking
mx of epiglottitis
ICU
intubated
IV Abs
what is bacterial tracheitis + organisms
bacterial infection of trachea
Hif, staph, strep
CF of bacterial tracheitis
toxic child
++ sore trachea
dx and mx of bacterial tracheitits
direct visualisation with endoscopy
ABX
what is bronchioloitis
viral LRTI
age for bronchioloitis
<12mo
organisms of bronchioloitis
RSV, metapneumovirus, influenza, parainfluenza
progression of bronchioloitis
peak day 2-5. resolves 7-10
cough can persist for 1mo
CF of bronchioloitis
coryzal sx cough wheeze decreased feeding irritability apnoea
mx of bronchioloitis
supportive paracetamol adn sucrose for comfort minimal handling breast feeding small amounts and frequently 2/3 maintence IVF o2 if sats <92%
criteria for admission of pneumonia
<3yrs
unwell
extensive consolidation
pleural effusion
mx of mild asthma
- 1x puff salbutamol
- reassess if effective can dc home
- if non effective mx as moderate
mx of moderate asthma
- o2 if sats <92%
- 1x puff salbutamol every 20 mins for 1hr
- PO prednisolone 2mg/kg then 1mg/kg for 2-3days
mx of severe asthma
- 02 if sats <92%
- 1x puff salbutamol every 20 mins for 1hr
- 1x puff ipatropium every 20 mins for 1hr
- aminophylline
- magnesium sulfate
- PO prednisolone of IV methylprednisolone
mx of critical asthma
SILENT CHEST
- o2
- nebulised salbutamol
- nebulised ipatropium
- IV CCS
- magnesium sufate
- aminophylline
DC requirements after asthma attack
- eating and drinking well
- no WOB
- asthma action plan!!!!!!
- correct inhaler technique
- safety net
- OPD or GP appt
what is the long term asthma control
releiver - salbutamol
preventor
ICS first!!!! or montelukast before combo or LABA
what are the indications for a preventor
sx when exercising
1+night/week waking up
1+/wk use of bronchodilator
what is the correct technique for inhaler use`
should always use a spacer
- remove cap from inhaler and shake well
- insert inhaler into spacer
- hold horizontally
- form seal around spacer with lips
- breathe out gently
- press inhaler once and breathe in normally 3-4x
- repeat if necessary
to clean use warm water and detergent. do not rinse. let drip dry dont use paper towel or cloth
what are the benefits of an asthma action plan
- D time away from schoo/work
- D hospitalisations
- D ED presentations
- I lung function
what is laryngomalacia
floppy larynx most common cause of congenital stridor most cases resolve by 1yr as larynx grows and cartilage rings harden can be exacerbated by URTI/LRTI often does not cause issues with feeding
how can CF present in neonate, infant and older children
neonate
- meconium ileus
- inestional atresia
- hepatitis/prolonged jaundice
infant
- rectal prolapse
- FTT
- malabsorption
older children
- recurrent chest infection
- nasal polyp
- liver disease
- DM
what organs does CF affect
lungs, pancreas, intestines, liver
how is CF dx
sweat test
heel prick test in infancy
