EM · Paediatric respiratory distress

Paediatric respiratory distress — croup, bronchiolitis and acute asthma

Also known as Croup · Laryngotracheobronchitis · Bronchiolitis · Paediatric asthma · Stridor in children · Wheeze in children

Paediatric respiratory distress — the three exam pillars of croup (subglottic viral oedema, inspiratory stridor, barking cough, dexamethasone 0.15 mg/kg orally with nebulised adrenaline 1:1000 at 0.5 mL/kg max 5 mL for moderate to severe), bronchiolitis (RSV bronchiolar obstruction, wheeze, hypoxia, supportive care with no routine bronchodilator or steroid), and acute asthma (salbutamol 2.5 to 5 mg nebulised, ipratropium, early steroid, magnesium sulfate 40 mg/kg), distinguished from the can't-miss mimics of foreign body aspiration, epiglottitis and bacterial tracheitis. The Poiseuille r-to-the-fourth rationale, the Westley croup score reproduced, weight-based dosing before any drug, and the escalation ladder from humidified oxygen through high-flow and non-invasive ventilation to intubation. ACEM-primary, globally tagged.