EM Final Lecture 5 - High Yield Peds _Emergencies Questions with correct answers | latest update | Complete Solution 2024

EM Final Lecture 5 - High Yield Peds
"Emergencies"
Croup (Laryngotracheobronchitis)
infection of the upper airways in children (6 mo to 3 years) characterized by a
seal-like barking cough. MCC Parainfluenza virus. The cough usually comes after
the viral prodrome. Scored via Westley Croup Index. Dx: Clinical. CXR shows
subglottic narrowing (steeple sign). Tx: Dexamethasone. (Epinephrine if severe).
Admit only if PulseOx<92%.




What is the MCC of Croup?
Parainfluenza virus
Steeple Sign
Classic sign of croup (tracheal narrowing with subglottic swelling) on lateral neck
x-ray.




What is the treatment for Croup?
Dexamethasone (1 dose)
Racemic mixture Epinephrine (if severe)
What pulse oximetry reading would warrant an admission for Croup?
<92%
Epiglottitis
inflammation of the epiglottis. True otolaryngologic emergency. Usually seen in
adults. Thumbprint sign on XR. Presents with the 3Ds: drooling, dysphagia, distress.
This is an airway and ENT emergency. Tx: Secure airway, O2, IVF, Epinephrine.
Ceftriaxone. (add vancomycin if concerned for MRSA). (cannot give neonate
ceftriaxone, give ampicillin instead)




Thumbprint Sign
Lateral XR finding of epiglottitis. (enlarged epiglottitis)