Stridor, Cough, Noisy Breathing Flashcards
What is stridor?
a term used to describe noisy breathing, in general, and to revere specifically to a high pitched crowing sound associated with croup, resp infection, and airway obstruction
inspiratory stridor
typically caused by obstruction or above the level of the vocal cords UPPER AIRWAY
expriratory stridor
usually localized to the more distal tracheobronchial tree.
biphasic stridor
usually AT VOCAL CORDS
child presents with stridor, cough, agitiation, hunger for air, severe retractions, cyanosis
extra thoracic airway obstruction.
Croup is…
acute layrngotracheobronchitis
Describe croup
inflammation of upper airway is present, but edema of the subglottic space accounts for the predominant signs of airway obstruction
When is croup most common? with who? what ages?
fall and winter, 6 mos to 3 years, boys more than girls
What organism is known for calling croup
parainfluenza types 1,2,3
What type of organism could cause life threatening croup?
bacterial–they look really sick. toxic, distressed appearance.
child had URI symptoms for several days, and then presents with seal bark cough, and inspiratory stridor.
croup. they are typically in MILD-to severe respiratory distress.
What is another type of croup?
spasmodic croup (no URI, viral symptoms) occurs for several nights in a row.
What is the diagnosis for croup?
physical and history. HOWEVER, you can get a xray and see the “steeple sign”.
How should you treat croup?
depends on severity of symptoms.
mild= oral hydration and minimal handling.
mod/severe= humidified cool air, IM corticosteroids, inhaled racemic epinephrine, loosening of secretions, decrease airway irritation and anxiety.
What does giving corticosteroids orally do?
decrease airway inflammation
What are the complications of croup?
viral pneumonia and bacterial tracheitis. Bac trach is VERY SERIOUS is you gave someone drugs for croup and they look way worse, then LIFE THREATENING…INTUBATION, ICU.
epiglottis
true medical emergency. inflammation of the epiglottis adjacent structures. incidence has dramatically decreased since HIB vaccine, protects agaisnt the h.influenzae agent.
when do most cases of epiglottis occur?
kids age 1-5. boys > girls.
what is the presentation of epiglottis?
rapid onset with fever.
tripoding position
drooling, respiratory distress, dysphagia
what is the classic sign seen with epiglottis?
thumb sign. lateral xray view needed.
what causes pertussis?
bordatella pertussis, there is a vaccine for this.
what are the 3 phases for pertussis?
- catarrhal : 1-3 weeks…coryza symptoms
- paraoxysmal cough: 2-4 weeks…10-30 staccato coughs
- convalescent: 4-12 weeks…bronchitic cough
known as the hundred day cough.
how do you treat pertussis?
erythormycin is DOC
corticosteroids may reduce severity
very poor prognosis if child is under 1 year. death occurs most often in this age group.
What is bronchiolitis?
inflammation of the bronchioles. most common serious acute respiratory illness in infants and young children.
CAUSED BY RSV
how does bronchiolitis present?
1-2 days cough, fever, rhinorrhea followed by TACHYPNEA (>50-60 bpm), TACHYCARDIA, chest retraction and prolonged expiratory phase.
what is bronchiolitis treatment?
supportive measure. abx not recommended.
hospitlize if <6 months, moderate to marked resp distress, hypoxemia, apnea, inability to tolerate oral feeding, appropriate home, high risk.
