Please enable JavaScript.

Coggle requires JavaScript to display documents.

Peds Upper Airway (Epiglotitis (Bacterial Tracheitis (Croup (Path:…

- - - - Path: Parainfluenza Virus
        
        Pt: Kids < 3mo :baby::skin-tone-3: to 3 y :boy::skin-tone-4:
        
        Viral prodrome
        
        progresses to bark (seal like cough) w/ an inspiratory wheeze (stridor) :wind_blowing_face:
        
        Dx: ~~XR : subglottic narrowing "steeple sign" :church:~~ (not sensitive nor specific)
        Croup is Croup
        
        pt may improve when breathing cold outside air :snowflake:
        Racemic Epi: improves overall condition
        
        Tx:
        
        Mild : misting, send :house:
        
        Mod : Racemic Epi, Steroids IM, O2 support prn
        
        Sev : Ongoing O2 & continued Racemic epic (hospital admission)
    - - Pt: Post Viral Prodrome
        
        wide range of kids: avg age 4 y :girl::skin-tone-4: (~ same as croup)
        
        more indolent, virus then recovery then sick
        
        Croup that does not improve!
        
        "Seal like bark" = Racemic Epi = no improvement
        
        Pt has slightly more Toxic (fever :fire:, leukocytosis)
        
        Dx: XR (shows steeple sign :church:, useless)
        
        racemic epic fails
        
        Consider bacterial.
        
        Tracheal Culture
        
        Tx:
        
        IV Abx
        
        Scope :telescope: for purulent, get culture
  - - - Dx: ~~XR : Thumbprint sign~~ (Emergent, Dx in the OR)
        
        Visualize Cherry red :cherries: swollen epiglottis while securing Airway
        
        Tx: Get the Airway!
        
        endotracheal tube in OR w/ anesthesiologist & ENT at bedside
        
        then… IV Abx
- - - - Anterior chain unilateral Lymphadenopathy
        
        Tender mass :volcano: (abscess)
        
        Dx: don't rush to OR
        
        CT scan
        
        Tx: I&D, incision and drainage or aspiration
        
        then… IV Abx
  - - - Pt: Adolescent >10yo :man::skin-tone-2:
        
        Hot potato :potato: Voice (muffled)
        
        Sore throat
        
        Drooling
        
        dysphagia / oodynophagia
        
        Uvular Deviation
        can see swollen tonsils shifted
        
        Dx: Clinical
        
        Tx: IV ABx
        
        then…I&D drainage