- most common of the croup syndromes
- viral invasion of the upper airway that extends throughout the larynx, trachea, and bronchi
- common in 6 months to 3 years
- caused by parainfluenza I, II, or III, influenza A and B, adenovirus, enterovirus, RSV
- preceded by URI
Croup - Laryngotracheobronchitis (LTB)
What are the clinical manifestations of LTB?
- upper respiratory symptoms
- inspiratory stridor
- seal like barking cough
- hoarseness
- labored respirations with retractions
- possible low grade fever
- tachypnea
- gradual onset at night
What might you see on an x ray of a child with croup?
steeple sign
What are the signs and symptoms of impending airway obstruction?
- increased HR and RR
- retractions and increased WOB
- nasal flaring
- restlessness
- Medical Emergency
- severe, rapid, progressive infection of the epiglottis and surrounding tissues.
- caused by influenza type B
acute epiglottitis
What are the 3 classic symptoms of acute epiglottitis?
- absence of spontaneous cough
- presence of drooling
- agitation due to hypoxia
Besides the 3 classic symptoms what are some other symptoms of acute epiglottitis?
- croaking on inspiration
- tripod position
- inspiratory stridor
- hyperextension of neck
What reduces the incidence of acute epiglottitis?
Hib vaccine
- forward sitting
- balanced on hands
- mouth open
- tongue protruding
- head tilted in sniffing position
classic tripod of child with epiglottits
What are the 4 D’s of epiglottitis?
Drooling
Dysphagia
Dysphonia (can’t talk)
Distressed respiratory effort
Do you look or throat swab a child with epiglottitis?
no
-qualified personal must be at bedside with emergency intubation equipment before examination and visual observation can be performed
What is the treatment for epiglottitis?
antibiotics and possible intubation
What are the important differences between croup and epiglottitis?
- Croup: symptoms get worse at night and better during the day
- Epiglottitis: tripod position and 4 D’s
