Stridor

Question 1

What is the definition of Stridor?

Answer 1

• The harsh, high-pitched sound of laryngeal and upper tracheal obstruction

Question 2

What are the causes of airway obstruction?

Answer 2

• Extramural (outside the wall)
• Intramural (in the wall)
• Inside the lumen (intraluminal)

Question 3

What is the Impending Airway Disaster Triad?

Answer 3

• Severe Dysphagia
• Rapid onset laryngeal voice change: hoarse, croaky, husky or no voice
• Systemically very unwell: pyrexia, tachycardia, tachypnoea
• Extra: Trismus/ Torticollis

Question 4

What is the immediate management of Stridor?

Answer 4

• Alert the emergency team
• Get the crash trolley/ emergency equipment
• Monitor oxygen sats
• Ask the patient to sit forward
• 1. Nebulised Adrenaline (1mg = 1ml of 1:1000 adrenaline)
• 2. Help needed: anaesthetist and ENT surgeon
• 3. IV access - bloods = group and save
• 4. High dose steroid = dexamethasone 8mg IV initally
• 5. Heliox = Helium and Oxygen
• 6. Endotracheal Intubation

Question 5

What is the immediate management of Stridor?

Answer 5

• Alert the emergency team
• Get the crash trolley/ emergency equipment
• Monitor oxygen sats
• Ask the patient to sit forward
• 1. Nebulised Adrenaline (1mg = 1ml of 1:1000 adrenaline)
• 2. Help needed: anaesthetist and ENT surgeon
• 3. IV access - bloods = group and save
• 4. High dose steroid = dexamethasone 8mg IV initally
• 5. Heliox = Helium and Oxygen
• 6. Endotracheal Intubation

Question 6

What emergency airways can be used?

Answer 6

• Open scalpel cricothyroidotomy
• Needle cricothyroidotomy