zulooelegant.blogg.se - Croup lung sounds

Examine the child in the parent's lap.Allow the patient to maintain a comfortable position (usually semi-upright).Keep the patient calm and minimize distress.May show hypoxemia and/or CO 2 retention.Indicated for severe respiratory symptoms, e.g., signs of impending respiratory failure.CBC: may help distinguish between bacterial and viral infections.Most commonly shows parainfluenza coinfections are common.Usually reserved for patients who do not respond to initial treatment.The steeple sign is not specific to croup it may also be present with bacterial tracheitis, epiglottitis, and noninfectious etiologies such as thermal injuries and neoplasms. Laryngoscopy/ bronchoscopy: may be performed for suspected foreign bodies or atypical croup.CT chest and neck: usually performed for differential diagnoses or suspected underlying congenital abnormalities.May show concurrent lower airway involvement.May identify subglottic narrowing on anteroposterior view ( steeple sign ).X-ray chest and neck (anteroposterior and lateral).Atypical presentation or diagnostic uncertainty, to rule out differential diagnoses of pediatric stridorĭo not delay treatment of stridor to perform diagnostic studies.Indications for diagnostic studies include:.

Diagnostic studies are not routinely required do not delay treatment in unstable patients to obtain studies.

Croup is most commonly diagnosed based on the presence of characteristic clinical features of croup.

Agitation can worsen symptoms and precipitate complete airway obstruction.ĭo not examine the throat of a child with significant stridor because the resulting agitation may precipitate complete airway obstruction.

Upper airway obstruction can cause pulsus paradoxus.

Hypoxemia, an altered mental state, and/or other signs of impending respiratory failure may be present.

Severe stridor and dyspnea are present at rest.

Affected individuals may be tachycardic or tachypneic.

Thoracic retractions are typically visible.

Stridor and dyspnea may be present at rest.

Mild croup: Stridor may be absent or only manifest in agitated individuals.

Characteristic features include seal-like barking cough, hoarseness, and inspiratory stridor due to subglottic narrowing.

Symptoms of croup last 2–7 days and typically manifest in the late evening/night.

Prodromal phase: 1–2 days of upper respiratory tract infection symptoms ( rhinitis, low-grade fever, sore throat ).

The prognosis of uncomplicated croup is good, and complete recovery typically occurs within seven days of onset. Patients with moderate or severe croup should also be evaluated for admission and receive nebulized racemic epinephrine and supplemental oxygen. All patients with viral croup should receive glucocorticoids (preferably dexamethasone) and supportive treatment.

Croup is primarily a clinical diagnosis, and diagnostic studies are only performed for severe disease, diagnostic uncertainty, or recurrent episodes of croup. More severe symptoms are associated with higher degrees of airway obstruction and include signs of respiratory distress, which can rarely progress to respiratory failure. This condition is characterized by a barking cough, hoarse voice, and inspiratory stridor, all of which often worsen at night. It is most often caused by the parainfluenza virus. Viral croup (i.e., acute laryngotracheobronchitis) is an inflammation of the upper airway that occurs in young children.