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Wile E. Coyote
Published in R. Annie Gough, Injury Illustrated, 2020
Cameron was an athletic and active 10-year-old blonde boy. He had a big smile, but had developed a stubborn, dry cough. For days and days his father hoped to soothe Cameron's cough with all the usual over-the-counter medications. Cameron became weak, not breathing well, truly struggling to get air. His father thought he could be wheezing or experiencing an asthma attack, but Cameron was not asthmatic. It was best to head to their pediatrician, and they did. Cameron's dry cough resembled croup. Croup refers to an infection of the upper airway, which obstructs breathing and causes a characteristic cough. The cough and other symptoms of croup are the result of swelling around the larynx, trachea, and bronchial tubes. When a cough forces air through this narrowed passage, the swollen vocal cords produce a noise similar to a bark, and taking a breath often produces a whistling, suffocating sound called stridor. Croup often begins as a typical cold, it is often worse at night, and is further aggravated by crying and coughing, as well as anxiety and agitation, setting up a cycle of worsening symptoms.
Cardiopulmonary Resuscitation
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
A child with croup will have a barking cough, harsh stridor and hoarseness, and will be frightened and miserable but not systemically ill. Give dexamethasone 0.15–0.3 mg/kg orally or i.m., nebulized budesonide 2 mg or prednisolone 1 mg/kg orally.Refer to the paediatric team.Epiglottitis (see p. 301)
Answers
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Croup (acute laryngotracheobronchitis) is an upper respiratory tract infection usually caused by parainfluenza virus. The virus causes subglottic oedema and inflammation, which causes a ‘barking’ cough, hoarseness and stridor. Dexamethasone is usually given as a one-off treatment and parents are told what to watch out for. In severe disease, nebulised adrenaline is also given, and if no response the patient will be taken to intensive care.
Lymphatic malformation in larynx masquerading as respiratory papillomatosis
Published in Acta Oto-Laryngologica Case Reports, 2021
He was admitted two weeks back in a local hospital in the intensive care unit with the diagnosis of Croup and was under mechanical ventilation for three days. He had no history of Asthma, Pulmonary tuberculosis, or any other chronic illness in the past. Flexible Nasopharyngolarygnoscopy in the clinic showed multiple papillomatous growths in the bilateral vallecula, the laryngeal surface of the epiglottis, bilateral aryepiglottic fold, and inter arytenoid area. We could not access the endolarynx properly in the flexible nasopharyngolarygoscopy in an outpatient clinic (Figures 1 and 2). We planned for emergency debulking under general anesthesia with a provisional diagnosis of Juvenile respiratory papillomatosis. Direct laryngoscopy under general anesthesia showed multiple cystic mass presents over bilateral vallecula, lingual and laryngeal surfaces of epiglottis (more on the left side), bilateral arytenoids and aryepiglottic folds, bilateral false vocal cords, lateral pharyngeal walls (more on the left side). But bilateral true vocal cords, subglottic area, and trachea were free of disease.
Multimedia Evaluation of EMT-Paramedic Assessment and Management of Pediatric Respiratory Distress
Published in Prehospital Emergency Care, 2021
Stephanie Schroter, Danny Thomas, Mark Nimmer, Alexis Visotcky, Raphael Fraser, M. Riccardo Colella, Lorin R. Browne
The importance of selecting the correct treatment for a respiratory condition is best demonstrated by looking at the physiology of each condition and how treatment addresses these physiologic changes. For example, asthma causes lower airway obstruction and is treated by β2-agonists (albuterol) that cause relaxation of the lower airways (4, 19–23). Conversely, croup causes upper airway obstruction due to edema of the upper airway caused by respiratory viral infections. Nebulized epinephrine acts through its α1 effect to cause vasoconstriction, addressing the edema, which leads to upper airway obstruction. Albuterol, being a β2 agonist has no significant effect on the α1 receptors making it ineffective for croup. In fact, albuterol’s β-effect could potentially cause and worsen vasodilation, leading to worsening upper airway edema (4, 19–23). Albuterol may also cause significant adverse effects such as tachycardia and tremors when inappropriately given to children with bronchiolitis. As with all inappropriate medication administration, misuse of these treatments for pediatric respiratory distress is associated with increased health care costs (24).
Prognostic factors and importance of recognition of adult croup
Published in Acta Oto-Laryngologica, 2018
Tomoyasu Tachibana, Yorihisa Orita, Takuma Makino, Yasutoshi Komatsubara, Yuko Matsuyama, Yuto Naoi, Michihiro Nakada, Yasuharu Sato, Kazunori Nishizaki
Croup, or laryngotracheobronchitis, is a common inflammatory disease in childhood characterized by barking cough, hoarseness, and stridor [1–3]. Severe croup patients can require airway intervention such as tracheal intubation or tracheostomy to maintain the airway. The characteristics of adult croup (AC) have not been well described. To delineate prognostic factors for AC, the present study retrospectively investigated the clinical features of AC patients treated in our department.