Trauma/Airway obstruction Flashcards
why can it be fatal if a newborn gets a blocked nose?
they are obligate nasal breathers, they cannot breathe through their mouth
what features of a new borns anatomy makes them more at risk of airway obstruction?
- large heads, small nasal openings
- nasal breathers
- relatively large tongue
- small, soft larynx
- weak neck muscles, floppy head
- narrow subglottis
how narrow is a neonates subglottis at the cricoid?
3.5mm
signs and symptoms of airway obstruction?
- SOB
- coughing
- choking
- stridor/stertor
- sternal/subcostal recession
- tracheal tug
- palor
- dysphagia
- dysphonia
- cyanosis
what is stridor?
high pitched harsh noise due to turbulent airflow resulting from airway obstructions
what is stertor?
low pitched sonorous sound arising from nasopharyngeal airway (snoring)
what is the problem with adenoid-tonsillar hypertrophy?
can cause airway obstruction
what causes recurrent respiratory papillomatosis?
HPV infection
where is recurrent respiratory papillomatosis seen?
on vocal cords
most common cause of adult subglottic stenosis?
vasculitis
should a tracheostomy be perfomed in a child or baby?
no, avoided at all possibilities
what are the important things to ask in a history of nasal trauma?
- mechanism of injury
- when
- loss of consciousness
- epistaxis
- breathing
why do young children not tend to break their noses?
as it is all cartilage
when does the nasal cartilage begin to ossify in children?
8/9/10 years old
what nerve can be damaged in a nasal trauma that can cause unilateral numbness of the nose and cheek?
infraorbital nerve
what problem should be excluded in a nasal trauma?
septal haematoma
why is it important to recognise and treat a septal haematoma fast?
it can cut off the blood supply to the cartilage and cause necrosis
how is a septal haematoma managed?
excised and the layers are stitched back together again
how is a nasal fracture diagnosed?
clinically
when is a nasal fracture reviewed in the ENT clinic after the injury?
5-7 days post-injury
why must you wait 5-7 days to see ENT after a nasal fracture?
so it can be assessed without all the swelling
managment of nasal fracture?
either no intervention or may have to put back into place
complications of a nasal fracture?
epistaxis, CSF leak, meningitis, loss of smell due to cribriform plate fracture
if a nosebleed does not stop in 15-20 mins, what should be given?
vasospasms
