Upper Respiratory Infection

Question 1

Risks associated with active or recent URI

Answer 1

Reactive airway (bronchospasm)
Laryngospasm
Mucous plugging
Atelectasis
Desaturation events
Post-operative hypoxemia

Question 2

Length of time most clinicians wait for surgery after URI

Answer 2

2-4 weeks after onset of symptoms

Question 3

Length of time associated with increased risk of pulmonary complications after URI

Answer 3

6-8 weeks

Question 4

Reasons to cancel procedure

Answer 4

Purulent nasal discharge
Fever (>38C or 100.4F)
Lethargy
Persistent cough
Poor appetite
Wheezing and rales that do not clear with cough
Child <1 year or previous preemie

Question 5

Reasons to proceed with caution

Answer 5

Clear rhinorrhea
No fever
Active
Appears happy
Clear lungs
Older child

Question 6

Airway approaches (lowest to highest risk)

Answer 6

Facemask
LMA
ETT (increases risk of bronchospasm 10-fold)

Question 7

ETT technique when intubating children with URI

Answer 7

Use smaller than normal tube

Question 8

Risk reduction

Answer 8

Avoid airway manipulation if possible
Dexamethasone (0.25-0.5 mg/kg)
Deep anesthetic plane
Propofol
Sevoflurane