Upper Airway Obstruction Flashcards
CHARGE SYNDROME
Coloboma Heart defect Atresia choanae Retarded growth and devt or CNS anomalies Genital anomalies or hypogonadism Ear anomalies
Upper Airway Obstruction
CROUP
Foreign Body Aspiration
Anaphylaxis
Viral CROUP
rhinorrhea, pharyngitis, low grade fever
STRIDOR (inspiratory)
hoarse voice
BARKING COUGH
CROUP (LARYNGOTRACHEOBRONCHITIS)
CLARS
cyanosis level of consciousness air entry retractions stridor
Neck x-ray finding in CROUP
STEEPLE SIGN - subglottic narrowing
Management of CROUP (MILD)
Dexamethasone
Management of CROUP (MODERATE TO SEVERE)
O2 NPO nebulized epinephrine dexamethasone re-assess after 2 hrs
Management of CROUP (IMPENDING RESPIRATORY FAILURE)
high O2 (NRM)
assisted ventilation for <90%
dexamethasone IV/IM
endotracheal intubation if indicated
3-7 yrs Hib rapid onset high grade fever THUMBPRINT/LEAF SIGN
Epiglottitis
3 mos-3 yrs
parainfluenza virus
low grade fever
STEEPLE SIGN
Viral CROUP
Signs of Upper Airway Obstruction
increased rate and effort
changes in voice, cry or presence of barking cough
stridor (inspiration)
poor chest rise
poor air entry on auscultation
drooling, snoring or gurgling sounds
(+) signs of upper airway obstruction
patchy infiltrates and ragged tracheal column
Bacterial tracheitis
antibiotics
(+) signs of upper airway obstruction
“THUMB’S SIGN)
Epiglottitis
(+) signs of upper airway obstruction
SUBGLOTTIC NARROWING (STEEPLE SIGN)
CROUP
(+) signs of upper airway obstruction
air trapping on the right lungs w/ mediastinal shift towards the right lung
Foreign Body Airway Obstruction
(+) sore, scratchy throat, nasal obstruction, rhinorrhea
prominent itching and sneezing
nasal eosinophilia
Allergic Rhinitis
(+) sore, scratchy throat, nasal obstruction, rhinorrhea
unilateral foul-smelling discharge
bloody nasal secretion
Foreign body in the nose
(+) sore, scratchy throat, nasal obstruction, rhinorrhea
headache, facial pain, periorbital edema, rhinorrhea > 2 weeks
Sinusitis
(+) sore, scratchy throat, nasal obstruction, rhinorrhea
persistent rhinorrhea w/ onset in the first 3 mos of life (snuffles)
Congenital Syphilis
(+) sore, scratchy throat, nasal obstruction, rhinorrhea
Hx of prolonged use of topical or oral decongestant
Rhinitis medicamentosa
(+) sore, scratchy throat, nasal obstruction, rhinorrhea
paroxysms of cough leaving the baby breathless and subconjunctival hemorrhages
Pertussis or whooping cough
Sinuses present at BIRTH
ME
maxillary
ethmoid
Sinuses pneumatized at 4 years old
sphenoid
Sinuses begin to develop at 7-8 years old
frontal
Ragged air column - CXR
Bacterial Tracheitis
MC organisms associated with sinusitis
S. pneumonia
Hib
M. catarrhalis
