Peds O- Oxygen, Airway, and Respiratory Disorders

Applying oxygen is one of the first steps in treating any crashing child!!! Airway Emergencies * Foreign body (FB)* Patient presentation* Stridor* Choking episode* Testing* CXR* May directly show foreign body* May show secondary effects of a foreign body* Hyperinflated/collapsed lobes of the lung* Patient needs bronchoscopy if suspicion is high* Peritonsillar abscess* Visible in the pharynx* Bacterial tracheitis* HIDDEN IN the airway* Epiglottitis* HIDDEN ABOVE the airway* Retropharyngeal abscess* HIDDEN BEHIND behind the airway* Common presentations of airway emergencies* Voice changes* Drooling* Stiff neck* Testing* Most are seen on neck X-Ray* Peritonsillar abscess is clinical diagnosis* Treatment* Manage the airway* IV Antibiotics * Peritonsillar abscess needs drainage Breathing Emergencies * Bronchiolitis = Badly breathing booger babies* Upper respiratory infection caused by virus* Signs of severe illness requiring admission* Grunting* Nasal flaring* Retractions* Hypoxemia* Unable to tolerate PO* Treatment* Deep suctioning* Can consider albuterol trial* Oxygen supplementation as needed* Generally avoid* Chest X-rays* Steroids* Antibiotics* Asthma* Treatment* First line* Albuterol/ipratropium* Steroids* Additional options as needed* Magnesium* Ketamine* IV epinepherine* Croup* Presentation* Barky cough* Stridor* Treatment* Steroids* Consider racemic epinephrine* Pneumonia* Diagnosed by x-ray* Treat with antibiotics* Cystic fibrosis* Albuterol/ipratropium* Nebulized saline* Antibiotics Additional Reading * Approach to Asthma (EM Clerkship)* More Than a Sore Throat (emDOCs)