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Stridor in children - Coggle Diagram

- - - - • Occur rapidly (acute onset )
      - • Without viral prodrome
      - • Toxic appearing child
      - • High grade fever
      - • Cough (rare) , Sore throat
      - • Inspiratory stridor
      - • Respiratory distress
      - • Dysphonia/aphonia
    - - Bacterial Infection
      - Haemophilus influenza type b (Hib)
    - - • Delay all testing until the airway is secure
      - • Blood cultures
      - • Epiglottis swab culture
      - • CBC (leukocytosis, left shift)
  - - - • Usually preceded by URTI
      - • Low grade fever
      - • Sudden or Gradual in onset
      - • Inspiratory stridor
      - • Parking cough
      - • Hoarseness of voice +/_ resp.distress
    - - viral infection
    - - • Conservative : Oxygen ,Hydration
      - • Nebulization with Racemic epinephrine
      - • Steroid
        
        ✓ Dexamethasone PO/IM ✓ Nebulized Budesonide
  - - - • The most common cause of inspiratory stridor in newborns & infant
      - • 45–75% of all infants have congenital stridor
      - • Omega shape of epiglottis , or elongation of epiglottis , sunken in of arytenoid, during inspiration
    - - Mild:
      - Observation, If symptoms worse required flexible laryngoscopy
      - Severe:
      - Surgery : Supraglottoplasty or Tracheotomy to bypass the obstruction is rarely performed
- - - - Endoscopic laser excision
    - - acquired
        
        • Prolong intubation
        • Low birth weight
        • GERD
      - congenital
        
        • Rare
        • associated with genetic disease.
  - - - • Congenital
        
        Cricoid cartilage deformity
      - • Acquired
      - Trauma – intubation - GERD
      - Treatment
        
        Endoscopic laser excision
  - - - Congenital
        
        2nd most common congenital defect of the larynx
      - Acquired
        
        Idiopathic – most common etiology Iatrogenic – surgical (heart surgery) prolong intubation
      - Treatment
        
        Observation - vocal cord may recover Voice therapy
        
        Re-innervation
        
        Injection a filler material Tracheotomy, NGT feeds
- - - - • Primary tracheomalacia
        
        Resolved with time
        
        -If Severe – tracheotomy – may need positive pressure ventilation
      - • Secondarytracheomalacia
        
        Compression by vascular structures
        
        Associated with tracheoesophageal fistula - Tracheotomy, treat underlying condition