16 Upper Airway

Croup

aka laryngotreacheobronchitis
path: parainfluenza
pt: 3 mo to 3 yrs
symptoms
- prodrome progress to barking/seal like cough, stridor in between
diagnosis
- xray: steeple sign, not very useful
- Clinical
treatment
- mild: misting and send home
- moderate: racemic epi and steroids IM, O2 supplementation
- severe: admit, ongoing racemic episode.,

path: staph aureus, following viral prodrome. The typical story is several days of viral upper respiratory symptoms, followed by an acute elevation of temperature and an increase in respiratory distress.
pt: 4 yo
symptoms
- more endolent
- croup does not improve with racemic epi or steroids
- may have more toxicity (higher fever, glucocytosis)
- biphasic stridor
diagnosis
- steeple sign
- racemic epi doesn't work
- tracheal culture + maybe scope
treatment
- IV antibiotics.,

path: H. Flu, Hib vaccine prevents
pt: 3-7 yo
symptoms
- rapid onset, high fever, very sick
- tripoding, drooling (hurts on swallow), using accessory muscles
- muffled voice
diagnosis
- Xray thumbprint sign
- visualize cherry red swollen epiglotitis
treatment: ET tube, antibiotics.,

path: oral floral
symptoms: very sick, abrupt onset, high fever, drooling, extended neck, neck stiffness, muffled voice
diagnosis
- anterior LAD, tender mass (abscess)
- CT scan
treatment
- I & D
- IV antibiotics.,

Last updated 5 years ago