15. You arrive on scene to find a 4 year old male in the care of his mother. Mom reports the child has become progressively more ill over the last 24 hours. You observe the child drooling, sitting forward in a tripod position and refuses to sit back. He feels warm to the touch, RR: 36 with mild retractions, HR: 130, Skin: Pink, warm and dry with refill < 2 seconds, palpable peripheral pulses. He appears ill and talks with stridor (hot potato voice) What is the issue?
19. Croup is an infectious illness of the respiratory system involving the voice box and vocal cords. A harsh crowing sound ("stridor") during inhaling can be heard when the child's air passage becomes abnormally narrowed
24. PPV PPV PPV will help open that obstruction even in a child in complete respiratory arrest.
25.
26. RSV Treatment Treating respiratory syncytial virus bronchiolitis "remains a good example of therapeutic nihilismโnothing works except oxygen". Adrenaline, bronchodilators, steroids, and ribavirin confer "no real benefitโ Treatment is supportive care only, with fluids and oxygen until the illness runs its course
27. Albuterol may be used in an attempt to relieve any bronchospasm if present. Increased airflow, humidified and delivered via nasal cannula, may be supplied in order to reduce the effort required for respiration. Recent studies with hypertonic saline have shown that the "use of nebulized 3% HS is a safe, inexpensive, and effective treatment for infants hospitalized with moderately severe viral bronchiolitis" where "respiratory syncytial virus (RSV) accounts for the majority of viral bronchiolitis cases"
28. ^ Jenny Handforth, Mike Sharland, Jon S Friedland. Editorial: Prevention of respiratory syncytial virus infection in infants. BMJ 2004;328:1026โ1027 (1 May), doi:10.1136/bmj.328.7447.1026
