Stridor

Question 1

What is stridor?

What is stertor?

Answer 1

High-pitched noise heard in inspiration due to partial obstruction at the larynx or large airways.

Inspiratory snoring noise coming from obstruction of the pharynx - remember A&E with the main on benzo’s

Question 2

Why does airway obstruction happen faster and more dramatically in children than in adults?

Answer 2

Children’s airways are narrower than adults

Question 3

What else should you look for along side stridor that could indicate impending completer obstruction? - 4

Answer 3

Swallowing difficulty/drooling
Pallor/cyanosis
Use of accessory muscles
Tracheal tug

Question 4

Causes:

• Congenital
• Inflammation
• Tumours
• Trauma

Answer 4

Laryngomalacia, web/stenosis, vascular rings

Laryngitis, epiglottitis, croup, anaphylaxis

Haemangioma’s or papillomas

Thermal/chemical or from intubation

Question 5

Epiglottitis - how does an adult present?

Management:

What 2 things needs to be done at first?

Who should be contacted? - 2

How is it diagnosed?

What is done after diagnosis?

Answer 5

Sore throat
Painful swallowing

Keep patient upright
Do not examine or distress patient as can make worse

Anaesthetist and ENT surgeon

Laryngoscopy

Patient intubated with dexamethasone and antibiotics

Question 6

Acute airway obstruction management:

Why is something called Heliox given?

What meds is given nebulised?

Who should be called?

Answer 6

Give Oxygen or Heliox (a mixture of helium and oxygen that is less dense than air so may reduce work of breathing

Adrenaline

ENT reg and anaesthetics

Question 7

Acute airway obstruction management:

3 surgical interventions

Answer 7

Endotracheal intubation - first line

Emergency needle cricothyroidotomy - temporary - will sustain life for 30-45 mins

Surgical cricothryoidotomy - quicker and easier than above - not done in children < 12yrs