Wong pediatrics lectures 4 and 5

More common in older children and adolescents usually

This preview shows page 9 - 11 out of 17 pages.

More common in older children and adolescents Usually viral Usually caused by virus Chief complaint is hoarseness Generally self-limiting and without long-term sequelae Not detrimental because it does not obstruct the airway Treatment: symptomatic Acute LTB LTB = laryngotracheobronchitis Most common of the croup syndromes Generally affects children <5 years Organisms responsible: RSV, parainfluenza virus, Mycoplasma pneumoniae , influenza A and B Winter-time type of sickness accompanied by a barking cough Manifestations of LTB Inspiratory stridor Suprasternal retractions Barking or seal-like cough Increasing respiratory distress and hypoxia Can progress to respiratory acidosis, respiratory failure, and death *Do pulse ox on this kid Therapeutic Management of LTB Airway management Maintain hydration (PO or IV) If they are very tachypneic they will not be able to drink so insert IV High humidity with cool mist Nebulizer treatments: Epinephrine (racemic Epi nebulizer to decrease swelling) Steroids Signs of Increasing Respiratory Distress in Children RESTLESSNESS – across all age groups Tachycardia Tachypnea Retractions Substernal Suprasternal Intracostal Acute Spasmodic Laryngitis (another form of croup) AKA spasmodic croup, midnight croup Barking cough This is the most common croup We wont need to differentiate between the types of croup Characterized by recurrent paroxysmal attacks of laryngeal obstruction Occur chiefly at night Inflammation: mild or absent Most often affects children ages 1-3 years Therapeutic management – same as management for infectious croup Bacterial Tracheitis Infection of the mucosa of the upper trachea Usually children <3 Distinct entity with features of croup and epiglottitis Clinical manifestations similar to LTB
Image of page 9

Subscribe to view the full document.

May be complication of LTB Thick, purulent secretions result in respiratory distress TXM with antibiotics Might be a complication of croup Seen in kids with cystic fibrosis The child has a history of previous URI with croupy cough, stridor unaffected by position, toxicity, absence of drooling, and high fever. Thick, purulent tracheal secretions are common, and respiratory difficulties are secondary to these copious secretions. The child’s white cell count will be elevated. Children with this condition may develop a life-threatening upper airway obstruction, respiratory failure, acute respiratory distress syndrome (ARDS), and multiple organ dysfunction Therapeutic Management of Bacterial Tracheitis Humidified oxygen Antipyretics: Tylenol and motrin Antibiotics May require intubation Infections of the Lower Airways Considered the “ reactive ” portion of the lower respiratory tract Includes bronchi and bronchioles Cartilaginous support not fully developed until adolescence Constriction of airways Bronchitis
Image of page 10
Image of page 11
  • Spring '14
  • Respiratory distress, clinical manifestations, respiratory tract, croup, cough-variant asthma

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern