Stridor Flashcards
What is stridor?
musical noise heard in inspiration from partial obstruction at the larynx or large airways
Why is stridor potentially more dangerous in children
childrens airways are narrower and more readily deformed
obstruction happens faster and more dramatically
What are congenital causes of stridor?
laryngomalacia
web/stenosis
vascular rings
What are inflammatory causes of stridor/\
laryngitis, epiglottitis, croup, anaphylaxis
What are other causes of stridor
tumours - haemangiomas or papillomas
trauma - thermal/chemical
foreign body
vocal cord paralysis
What usually causes croup?
parainfluenza virus
When is the peak incidence of croup?
6m - 3yrs
What time of year is croup moree common?
autumn
How does croup usually present>
barking cough - worse at night
stridor
fever
coryzal sx
What causes the stridor in croup?
laryngeal oedema and secretions
What is the usual rx of croup
usually self limiting so can be treated at home
What is rx of severe croup
abx
humidified O2
nebulised adrenaline
dexamethasone
What causes acute epiglottitis?
haemophilus influenza type b
How does acute epiglottitis usually present?
NO cough Rapid onset Stridor Drooling of saliva Sore throat SOB
What is peak age of epiglottitis?
2-6yrs
What is the management of epiglottis?
ITU - dont examine the throat!!!
O2 by mask
Give nebuliser adrenaline, IV dexamethasone
IVI + penicillin G + ceftriaxone
What is laryngomalacia?
congenital abnormality of larynx
When does layryngomalacia typically present and how?
between hours and weeks of birth
What is the character of the stridor in laryngomalacia?
noticeable in certain positions, sleep or if excited/upset
What is the treatment of laryngomalacia?
usually none, improves by 2yrs in most
If severe - surgery
How does unilateral laryngeal paralysis present?
during 1st weeks of life w:
hoarse breathy cry aggravated by agitation, feeding difficulties +/- aspiration
How does bilateral laryngeal paralysis present?
inspiratory stridor at rest that worsens upon agitation +/- significant resp distress
What is rx of unilateral laryngeal paralysis?
supportive as most recover by 2-3yrs
What is rx of bilateral laryngeal paralysis?
may need urgent airway intervention +/- surgery
