Pathophysiology
Whats in a name?
Severe Illness
Close your eyes and listen
Treatment
100
This illness affects the upper airway/larynx
What is Croup?
100
What is the official name for croup?
Acute laryngotracheal bronchitis
100
Which illness is leading cause of hospitalization in children?
Bronchiolitis
100
Close your eyes and listen
What is this?
100
What is the treatment for bronchiolitis?
Oxygen, nasal suctioning, hydration
200
Both illnesses primarily affect children under what age?
2
Croup most common: 6months-3
can affects kiddos up to 5
200
What is most common cause of Bronchiolitis?
1. RSV
2. Rhinovirus
3 Parainfluenza, Influenza, Adenovirus, Coronavirus
**1/3 kiddos have 2 viruses concurrently
200
Name 3 possible complications of bronchiolitis
Apnea, Pneumonia, Dehydration, Respiratory Failure
200
What is treatment for mild croup (at home treatment)
Steam, cold air
Antipyretics
Fluids
300
Bronchiolitis affects which part of the airway?
Bronchiolitis occurs when viruses infect the terminal bronchiolar epithelial cells, causing direct damage and inflammation in the small bronchi and bronchioles. Edema, excessive mucus, and sloughed epithelial cells lead to obstruction of small airways and atelectasis
300
What are indications for hospitalization in bronchiolitis
Toxic appearance, poor feeding, lethargy, or dehydration
●Moderate to severe respiratory distress ( nasal flaring; intercostal, subcostal, or suprasternal retractions; respiratory rate >70 breaths per minute; dyspnea; or cyanosis)
●Apnea
●Hypoxemia with or without hypercapnia SpO2 (oxygen saturation) <95 percent
●Parents who are unable to care for them at home
300
What medicine can we give in office to help mild to moderate croup?
- single dose of oral dexamethasone (0.15 to 0.6 mg/kg, maximum dose 16 mg)
400
What are key features of croup?
inspiratory stridor, barking cough, and hoarseness
400
Croup is caused by....
1. parainfluenza 1 (especially fall and winter)
2. PI 2 and 3
3. RSV, Adenovirus, MEASLES!
400
Name 3 risk factors for severe bronchiolitis
Prematurity (gestational age ≤36 weeks)
●Low birth weight
●Age less than 12 weeks
●Chronic pulmonary disease, particularly bronchopulmonary dysplasia (also known as chronic lung disease)
●Anatomic defects of the airways
●Hemodynamically significant congenital heart disease
●Immunodeficiency
●Neurologic disease
400
Moderate to severe croup treatment includes:
dexamethasone (0.6 mg/kg) and racemic epinephrine
500
What are key features of bronchiolitis?
fever (usually ≤38.3°C [101°F]), cough, and respiratory distress (eg, increased respiratory rate, retractions, wheezing, crackles). It often is preceded by a one- to three-day history of upper respiratory tract symptoms (eg, nasal congestion and/or discharge)
500
Who can name this radiologic finding?
500
Define physical exam findings that would indicate respiratory distress
Hypoxemia
RR>60 (tachypnea)
Apnea
Hypoxia
Restractions
Flaring
500
How soon can you send them home from ER after treatment?
Wait at least 3-4 hours