Upper respiratory infection Flashcards
Acute stridor causes?
What might a child do if they had stridor which is quite traumatic for them?
Viral croup
Bacterial Trachetis
Epiglottitis - rare due to haemophilus vaccine
Foreign body
Hyperventilate
Investigations for epiglottitis
X-ray as it is epiglottitis is an emergency
Technical name for croup
laryngotracheobronchitis
Croup:
Signs - 3
At what age does it typically affect?
When is it most prevelant
Which pathogen is reponsible
Pathophysiology
How is it classified?
Stridor
Barking cough
Hoarseness
<6yrs but can be seen in older atopic children
Autumn
Paroinfluenza virus 1, 2 and 3 etc.
Subglotic oedema, inflammation and exudate
Mild/moderate to severe
Croup:
What does it mean that it is mild/moderate disease?
What —– severe disease?
Minimal recession/stridor
No cyanosis
Alert child
Restlessness cynosis recession stridor at rest rising pulse/RR tiredness altered conscious level
Croup:
Rx for mild/moderate disease:
2 meds - dose
Rx for severe disease?
Why is stridor important in severe disease?
Dexamethasone 0.15mg/kg PO STAT
or
Prednisolone 1-2mg/kg STAT
Nebulised Adrenaline 1:1000 400mcg/kg
Repeat and take to ITU
Stridor will be softer or there will be a snoring sound whihc indicates poor airflow
If you suspect croup and you provide treatment, if it doesn’t work then you should suspect?
Bacterial tracheitis
What is bacterial tracheitis
What would increase your risk of it
S+S
Management
Bacterial infection of trachea
Following a viral URTI due to mucosal damage and local immune changes
Stridor
Purulent secretions
Mucosal necrosis and sloughing
High fever
IV antibiotics
Epiglotitis:
Main pathogen?
When is it most common?
Why is the prevalence falling?
Haemophilus influenze type b (Hib)
1-6 yrs
Hib vaccine
Epiglotitis:
S+S
Systemic symptom
What could be sore?
What about the secretions?
What about the stridor?
Voice changes?
What is tripoding?
High fever
Sore throat
Drooling as they can’t swallow secretions
Stridor - soft and continuous - a lare sign which suggests obstruction
Whispering
Tripoding - sitting and learning forward on outstretched arms to easr upper airway obstruction
Epiglotitis:
Management:
What senior help is needed?
What should you do for low SATS?
Why you shouldn’t do oral examination or gain IV access?
What if their airway is comprimised?
What is definitve Rx?
Anesthetics
Paediatrics
ENT
Oxygen/Heliox
It can precipatate respiratory distress
Nebulised adrenaline
Intubation and IV antibiotics
Epiglotitis:
How is it diagnosed?
Investigations?
Laryngoscopy during intubation
Lateral neck XR
Blood culture and neck swabs
Differentials for cough for children
Infection Asthma, allergic rhinitis Passive smoking Inhaled foreign body, aspiration CF Habit cough
Differentials for stridor for children
What is stridor? What does it suggest?
Infection - croup, BT, epiglotitis Anaphylaxis Inhaled foreign body Laryngomalacia Tracheomalacia
Harsh, high pitched sound which is usually inspiratory - suggests URT problems
Inhaled foreign body:
Classic triad
Investigatio
Persistent cough and choking after - choking can be missed and symptoms can last for weeks before diagnosis
Wheeze
Reduced lung sounds
