these emergencies often present to family practitioner...
some are trivial to the medical professional but are serious for the patient, while most are acute emergencies that require prompt referral and management to prevent further complications
pictures taken from google images...
4. Saccular cysts
Similar to
laryngoceles
Filled with mucous
May need
immediate
trach/intubation*
Endoscopically vs.
open
5. Congenital High Upper Airway Obstruction
(CHAOS)
1994– ultrasound with large lungs, flat
diaphragms, dilated airways, fetal ascites
EXIT procedure (ex utero intrapartum
treatment)
Multidisciplinary team
C-section, maintain placental blood flow, quick tracheotomy
6. Subglottic stenosis
Acquired or
congenital
Failure of laryngeal
lumen to recanalize
Membranous vs.
cartilaginous
Other anomalies
Less than 4.0 mm
(3.5 mm)
7. Subglottic stenosis
Respiratory distress
at delivery to
recurrent croup
Usually not at birth*
History and PE
(biphasic stridor)
Endoscopy
Cotton grading
system
10. Usually put in by
patient, some bugs fly
in
kill bugs with mineral
oil, or lidocaine
remove with forceps,
suction or tissue
adhesive
Complication:
Infection & mucosal
erosion
11. Hematoma
- cartilaginous necrosis
- drain, antibiotics, bulky
ear dressing close
follow up
Lacerations -
single layer closure,
pick up
perichondrium, bulky
ear dressing
Use posterior auricular
block for anesthesia
12.
13.
14. Extremely painful
Will cause canal
stenosis if not
immediately
treated
Iccthammol pack
or bipp pack (short
duration)
18. Serous Otitis Media -
Eustachian tube dysfunction
- treat with decongestants,
decompressive maneuvers
Otitis Media - infection of
middle ear effusion - viral
and bacteria
Mastoiditis - Venous
connection with brain, need
aggressive treatment (can
lead to brain abcess or
meningitis)
30. Most common
kesselbach’s plexus
Squeeze nose tip 5-20
mins
Insert cotton pledget
(with decongestant
Cautery with sliver
nitrate
Initial first aid
Assessement of blood
loss
Evaluation of cause
Procede to stop
bleeding
31.
32. severe bleeding
hypoxia, hypercarbia
sinusitis, otitis media
necrosis of the columella or nasal ala
33.
34.
35. Signs and symptoms
- H/A, facial pain in sinus
distribution
- purulent yellow-green
rhinorrhea
- fever
- CT more sensitive than
plain films
Causative Organisms
- gram positives and H. flu
(acute)
- anaerobes, gram neg
(chronic)
36. Treatment
acute - amoxil, septra
chronic - amoxil-clavulinic acid,
clindamycin, quinolones
decongestants, analgesia, heat
Complications
ethmoid sinusitis - orbital
cellulits and abcess
frontal sinusitis - may erode
bone (Potts Puffy Tumor,
Brain Abcess)
37.
38. Most common
strept and staph,
Rarely H.Flu
Can progress
rapidly
Admit broad
spectrum
antibiotics
39.
40.
41.
42. Very Opaque:
Cod, Haddock, Cole fish, Lemon sole,
Gurnard
Moderate Opaque:
Grey Mullet, Plaice, Monkfish, Red
Snapper
Not Opaque:
Herring (Kipper), Salmon, Mackerel,
Trout, Pike
45. Complication of suppurative
tonsillitis
Inferior - medial displacement
of tonsil and uvula
dysphagia, ear pain, muffled
voice, fever, trismus
Treatment
- Antibiotics, I&D, +/-steroids
46. common presentation of primary herpes simplex
virus (HSV) infection in young children is herpetic
gingivostomatitis.
children ages 6 months to 5 years.
significant discomfort and disturbing appearance
The primary infection may present with associated
flu-like symptoms, including an abrupt onset of
high fever, irritability, and malaise.
Oral findings include erythematous, edematous,
and friable gingivae as well as oral and perioral
clusters of vesicles, which coalesce to form large,
painful ulcers. Symptoms usually last less than 1
week but may continue for up to 21 days
47. Children 3 – 7 yrs and adults
decrease incidence in children
secondary to HIB vaccine
Onset rapid, patients look
toxic
prefer to sit, muffled voice,
dysphagia, drooling,
restlessness
48. Avoid agitation
Direct visualization if patient allows
soft tissue of neck
- thumb print, valecula sign
Prepare for emergent airway, best achieved in a
controlled setting
Unasyn, +/- steroids
50. Anterior to prevertebral
space and posterior to
pharynx
Usually in children under 4
(lymphoid tissue in space)
pain, dysphagia, dyspnea,
fever
swelling of retropharyngeal
space on lateral x-ray
Complications -
mediastinitis