EM Final Lecture 5 - High Yield Peds
"Emergencies"
Croup (Laryngotracheobronchitis)
infection of the upper airways in children (6 mo to 3 years) characterized by a
seal-like barking cough. MCC Parainfluenza virus. The cough usually comes after
the viral prodrome. Scored via Westley Croup Index. Dx: Clinical. CXR shows
subglottic narrowing (steeple sign). Tx: Dexamethasone. (Epinephrine if severe).
Admit only if PulseOx<92%.
What is the MCC of Croup?
Parainfluenza virus
Steeple Sign
Classic sign of croup (tracheal narrowing with subglottic swelling) on lateral neck
x-ray.
What is the treatment for Croup?
Dexamethasone (1 dose)
Racemic mixture Epinephrine (if severe)
What pulse oximetry reading would warrant an admission for Croup?
<92%
Epiglottitis
inflammation of the epiglottis. True otolaryngologic emergency. Usually seen in
adults. Thumbprint sign on XR. Presents with the 3Ds: drooling, dysphagia, distress.
This is an airway and ENT emergency. Tx: Secure airway, O2, IVF, Epinephrine.
Ceftriaxone. (add vancomycin if concerned for MRSA). (cannot give neonate
ceftriaxone, give ampicillin instead)
Thumbprint Sign
Lateral XR finding of epiglottitis. (enlarged epiglottitis)
"Emergencies"
Croup (Laryngotracheobronchitis)
infection of the upper airways in children (6 mo to 3 years) characterized by a
seal-like barking cough. MCC Parainfluenza virus. The cough usually comes after
the viral prodrome. Scored via Westley Croup Index. Dx: Clinical. CXR shows
subglottic narrowing (steeple sign). Tx: Dexamethasone. (Epinephrine if severe).
Admit only if PulseOx<92%.
What is the MCC of Croup?
Parainfluenza virus
Steeple Sign
Classic sign of croup (tracheal narrowing with subglottic swelling) on lateral neck
x-ray.
What is the treatment for Croup?
Dexamethasone (1 dose)
Racemic mixture Epinephrine (if severe)
What pulse oximetry reading would warrant an admission for Croup?
<92%
Epiglottitis
inflammation of the epiglottis. True otolaryngologic emergency. Usually seen in
adults. Thumbprint sign on XR. Presents with the 3Ds: drooling, dysphagia, distress.
This is an airway and ENT emergency. Tx: Secure airway, O2, IVF, Epinephrine.
Ceftriaxone. (add vancomycin if concerned for MRSA). (cannot give neonate
ceftriaxone, give ampicillin instead)
Thumbprint Sign
Lateral XR finding of epiglottitis. (enlarged epiglottitis)
