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Assessment & Management of Acute Upper Airway Obstruction in Children

Assessment & Management of Acute Upper Airway Obstruction in Children . Differential Diagnosis: Acute Upper Airways Obstruction. Croup: Viral Laryngotracheobronchitis (very common) Recurrent or spasmodic croup (common) Bacterial tracheitis (rare).

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Assessment & Management of Acute Upper Airway Obstruction in Children

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  1. Assessment & Management of Acute Upper Airway Obstruction in Children

  2. Differential Diagnosis:Acute Upper Airways Obstruction • Croup: • Viral Laryngotracheobronchitis (very common) • Recurrent or spasmodic croup (common) • Bacterial tracheitis (rare)

  3. Differential Diagnosis:Acute Upper Airways Obstruction • Rare Causes: • Epiglottis • Inhalation of smoke and hot air in fires • Trauma to the throat • Retropharyngeal abscess • Laryngeal foreign body • Angioedema • Infectious mononucleosis • Measles • Diphtheria • Acute-on-chronic stridor e.g. a floppy larynx (laryngomalacia)

  4. Acute Laryngotracheobronchitis-1

  5. Acute Laryngotracheobronchitis-1

  6. Acute Laryngotracheobronchitis-2

  7. Acute Laryngotracheobronchitis-2

  8. Sign ? steeple`s

  9. Sign ? steeple`s ass.w. Croup

  10. Spasmodic Croup-1

  11. Spasmodic Croup-1

  12. Spasmodic Croup-2

  13. Spasmodic Croup-2

  14. ? thumb print sign ass.w. epiglottitis

  15. thumb print sign ass.w. epiglottitis

  16. Epiglottitis - 1

  17. Epiglottitis - 1

  18. Epiglottitis -2

  19. Epiglottitis - 2

  20. ? unilat.(Lt) swelling

  21. retrophar. abscesc غير واضح؟

  22. Retropharyngeal Abscess-1

  23. Retropharyngeal Abscess-1

  24. Retropharyngeal Abscess-2

  25. Retropharyngeal Abscess-2

  26. Angioedaema-1

  27. Angioedaema-1

  28. Angioedaema-2

  29. Angioedaema-2

  30. ? laryng papilloma

  31. Laryngeal Papillomatosis-1

  32. Laryngeal Papillomatosis-1

  33. Laryngeal Papillomatosis-2

  34. Laryngeal Papillomatosis-2

  35. norm. inspir. CXR

  36. expir. CXR , Lt lung is obstruc. by Hemangioma

  37. Can a haemangioma cause an airway obstruction ?

  38. Lower Airway Diseases - Acute • Asthma • Bronchiolitis • FB • Aspiration of Gastric contents

  39. Asthma - assessment of severity • Altered consciousness or agitation • Exhaustion • Ability to talk – sentences, phrases or words • Feeding & drinking • Central cyanosis • Accessory muscle use • Sternal recession • Heart rate ( >6 years) 100, 100-120, >120 • Wheeze • Pre-neb sats: >93%, 91-93% & <90% • PaCO2: > 5 kpa

  40. Acute severe asthma • High flow oxygen 10-15 litres (mask & res) • Neb Salbutamol +/- Ipratobium – 20 -30min • IV access • IV Hydrocortisone 4mg/kg x 4 hours • IV Salbutamol 15 mcg/kg (5mcg/kg <2 yrs) over 10 min – 1-5 mcg/kg infusion • +/- IV Aminophylline Infusion 5mg/kg 15-20 min

  41. Lower Airway Diseases - Chronic • Asthma – reactive airway disease • Hypersensitivity reactions • Tracheo-bronchomalacia • Vocal cord adduction • Airway compression • Aspiration (FB, GOR, Swallowing dysfunction, TOF) • Bronchiectasis, CF, PCD (ICS), Tumours, Bronchiolitis obliterans, post BPD • CCF

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