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stridor pediatric emergency

Sahba Sedaghat, Mario Tapia, Felipe Fredes, Pablo Rojas
INTRODUCTION: Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morbidity and mortality in pediatric patients. New conservative procedures have emerged to treat this condition thus avoiding tracheostomy, like endoscopic anterior and posterior cricoid split (EAPCS)...
June 2017: International Journal of Pediatric Otorhinolaryngology
Candice L Bjornson, Janielee Williamson, David W Johnson
OBJECTIVE: The objective was to derive a simple clinical scoring instrument for assessing children with croup by telephone for use in clinical research studies. METHODS: We reviewed published literature on croup scores, surveyed experienced pediatric emergency nurses and physicians, and conducted a prospective cohort study. Score items were derived from published literature and surveys of experienced clinicians. We enrolled children with croup attending an urban pediatric emergency department...
May 2016: Pediatric Emergency Care
Jenna O Miller, Satid Thammasitboon, Deborah C Hsu, Manish I Shah, Charles G Minard, Jeanine M Graf
OBJECTIVE: Research has shown that patients transported by nonpediatric teams have higher rates of morbidity and mortality. There is currently a paucity of pediatric standardized ongoing medical education for emergency medical service providers, thus we aimed to develop a model curriculum to increase their knowledge regarding pediatric respiratory distress and failure. METHODS: The curriculum was based on the Kolb Learning Cycle to optimize learning. Target learners were flight nurses (registered nurse) and emergency medical technicians of a private helicopter emergency transport team...
February 2016: Pediatric Emergency Care
Anirban Mandal, Sushil K Kabra, Rakesh Lodha
Children with upper airway obstruction are both unique and variable in their presentation and management, often posing a challenge to the pediatrician. Several anatomical and physiologic peculiarities make a child vulnerable to develop an obstruction of upper airways. The characteristic finding in upper airway obstruction is stridor-inspiratory, biphasic or expiratory. The etiologies vary widely throughout the age groups and according to the mode of presentation. The approach starts with suspicion, mandates careful clinical evaluation of the degree of obstruction and many a times emergency measures precede any investigation or even precise diagnosis...
August 2015: Indian Journal of Pediatrics
Hyun Jee Kim, Je Do Son, Kyung-Hwa Kwak
An 18 month-old boy underwent endoscopic foreign body removal under anesthesia on an outpatient basis and the operation took approximately 5 minutes. Stridor developed in both lung fields 6 hours after emergence from anesthesia, and severe croup developed, with cyanosis of the lips and aggravated stridor 20 hours after the end of the procedure. The croup resolved with oxygen therapy, intravenous dexamethasone, and epinephrine nebulization therapy. In this report, we suggest that thorough investigations of the patient's past history, including history of any airway problems, and careful monitoring after emergence from anesthesia be done in order to decide the proper discharge time of the patient...
October 2014: Korean Journal of Anesthesiology
B S Sharma, Dhananjay S Shekhawat, Prity Sharma, Chetan Meena, Hari Mohan
Acute respiratory distress is one of the most common reason for emergency visits in children under 5 y of age. An accurate understanding of the epidemiology of these diseases, identification of risk factors and etiology is critical for successful treatment and prevention of related mortality. The cause of acute respiratory distress varies in etiology, and hence is amenable to different treatment modalities. Depending on the predominant symptoms and signs, a child presenting to the clinician can be divided into six groups, viz...
July 2015: Indian Journal of Pediatrics
Sapna R Kudchadkar, Justin T Hamrick, Christine L Mai, Ivor Berkowitz, David Tunkel
BACKGROUND: Thermal epiglottitis is a rare but potentially life-threatening disease. Diagnosis requires a thorough history and high clinical level of suspicion, particularly in children. Thermal epiglottitis from steam inhalation can have a slow onset without oropharyngeal signs of thermal injury, findings that can hide the clinical diagnosis. OBJECTIVE: Our aim was to review the pathophysiology and clinical presentation of thermal epiglottitis and the challenges involved in diagnosis and management of this form of atypical epiglottitis...
February 2014: Journal of Emergency Medicine
A Duhamel, D Grevent, V Nouyrigat, G Cheron
We report the case of a patient who presented dyspnea due to a large intrathoracic goiter. This patient had congenital hypothyroidism due to thyroid enzyme deficiency. He came to a pediatric emergency department for dyspnea. At home, he had inspiratory and expiratory dyspnea with a stridor. No signs of respiratory distress were observed. The neck was deformed by a large goiter. The patient indicated that he did not follow the recommended L-thyroxine treatment. Chest and neck radiography showed tracheal compression...
June 2013: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
M Jayashree, Sunit C Singhi
Triage refers to quick assessment of a patient in the Emergency Room with a view to define urgency of care and priorities in management. Triage evaluation can be completed in an organized and systematic manner using Pediatric Assessment Triangle (PAT), which refers to immediate visual and auditory assessment of appearance, breathing and circulation. At the end of PAT, patient's illness is categorized as either stable or unstable. Unstable conditions are further classified into life threatening and non life threatening...
September 2011: Indian Journal of Pediatrics
Xu Zhang, Wenxian Li, Yinzi Chen
OBJECTIVES:   To identify the risk factors associated with postoperative adverse respiratory events in preschool-aged children with inhaled foreign bodies (FBs) undergoing rigid bronchoscopy. BACKGROUND:   Foreign bodies aspiration is the most common cause of admission in pediatric emergency in otolaryngology service. Performance of rigid bronchoscopy is the standard treatment for removal of FBs in children. In some cases, severe respiratory events (complete laryngospasm and pneumothorax) may cause anesthesia-related morbidity and mortality...
October 2011: Paediatric Anaesthesia
Kerry Caperell, Raymond Pitetti
OBJECTIVE: To prospectively investigate whether American Society of Anesthesiologists (ASA) class, as assigned by nonanesthesiologists, is associated with adverse events during procedural sedation in a pediatric emergency department. METHODS: A prospectively collected database of children aged 0 to 21 years undergoing procedural sedation in the emergency department of an urban, tertiary care, children's hospital was retrospectively reviewed. This database included clinical and demographic characteristics, including assigned ASA class...
October 2009: Pediatric Emergency Care
Makoto Komura, Yutaka Kanamori, Masahiko Sugiyama, Noriyoshi Fukushima, Tadashi Iwanaka
Most patients with thymic cysts complain of a slowly enlarging, asymptomatic cervical mass. Only 6-10% suffer dysphagia, dyspnoea, stridor, cervical pain or vocal paralysis. In some rare cases sudden onset of severe dyspnoea or asphyxia is the first symptom, especially in neonates and small infants. We report a unique case of a 20-month-old child, who required emergency tracheal intubation due to asphyxia. Cervicomediastinal thymic cyst might need to be included in causes of life-threatening airway obstruction in young children...
September 2010: Pediatric Radiology
Hedwig Schroeck, Karamarie Fecho, Kathleen Abode, Ann Bailey
OBJECTIVE: In children undergoing bronchoscopy for evaluation of stridor or respiratory symptoms, movement of the vocal cords is routinely assessed at the conclusion of flexible bronchoscopy with children still anesthetized. The effect of anesthesia on vocal cord function is not well described. This study aimed to characterize the relationship between depth of propofol anesthesia, as measured by Bispectral Index (BIS), and vocal cord movement in pediatric patients. METHODS: Children between 6 months and 12 years of age presenting for diagnostic flexible bronchoscopy were enrolled in this prospective observational study...
May 2010: Pediatric Pulmonology
Biswajit Dubashi, Sanju Cyriac, Sagar Gnana Tenali
BACKGROUND: Primary mediastinal malignancies are uncommon. They can originate from any mediastinal organ or tissue but most commonly arise from thymic, neurogenic, lymphatic, germinal or mesenchymal tissues. OBJECTIVES: The aim of this study was to review the clinical presentations, diagnostic methods adopted, the histologies and the treatment outcomes of this rare subset of tumors. MATERIALS AND METHODS: Case records of 91 patients in the period 1993-2006 at our institute were retrospectively analyzed...
July 2009: Annals of Thoracic Medicine
Amit Srivastava, Vinod Ravindran
Though hypocalcemic stridor is a well-recognized pediatric emergency, it has rarely been reported in the elderly, and hypocalcemia of nutritional origin presenting with stridor in this group has not previously been reported. We report an elderly patient who presented with stridor and intermittent sudden airway obstruction resulting from laryngospasm secondary to hypocalcemia of nutritional origin and we present a brief review of this life-threatening complication of hypocalcemia.
May 2008: European Journal of Internal Medicine
Joshua Nagler, Jason A Levy, Richard G Bachur
Stridor is a common presentation to the pediatric emergency department. The differential diagnosis is broad and includes conditions that range from benign to immediately life threatening. The evaluation and management of pediatric patients with stridor can vary, depending on the likely diagnoses and the acuity of the presentation. We report a case of an infant with known myelomeningocele who presented to the emergency department with stridor and the use of ultrasound to diagnose Chiari crisis as the etiology of her symptoms...
July 2007: Pediatric Emergency Care
Paul K Nolan, Marjorie Chrysler, Gary Phillips, Deborah Goodman, Lee S Rusakow
PURPOSE: Spirometry performed by adolescents with refractory wheeze or stridor and respiratory distress, with normal room air oxygen saturation, may differentiate subjects not having an acute asthma exacerbation (AE-) from those who are (AE+). A subpopulation may also be identified that has flow volume loop (FVL) patterns consistent with vocal cord dysfunction (VCD). METHODS: Spirometry was performed by adolescents who presented to a pediatric emergency department (ED) with respiratory distress attributed to an acute AE who, after therapy, were still symptomatic and had room air oxygen saturation > or = 97%...
July 2007: Pediatric Pulmonology
J Rachel Homer, Tom Elwood, Do Peterson, Sally Rampersad
BACKGROUND: Recent upper respiratory infection (URI) in children increases respiratory adverse events following anesthesia for elective surgery. The increased risk continues weeks after resolution of acute URI symptoms. Few systematic analyses have explored specific risk factors. This logistic regression explores the relationship between preoperative URI symptoms and adverse events during emergence from anesthesia. METHODS: Data were combined from control groups of several prospective observational and interventional studies in elective pediatric anesthesia in a tertiary care pediatric hospital...
February 2007: Paediatric Anaesthesia
Geoff Murphy, Sam Bartle
Stridor is a common presenting sign of respiratory illness in the pediatric population-especially in the winter. Infrequently, tetany as a chief complaint may be seen with tetanus, seizures, and dystonic reactions to medications. There are few medical conditions that present with both symptoms. This is a case of a patient who presented to our emergency department in early winter with both stridor and tetany. The child was diagnosed with hypocalcemia resulting from a previously undiagnosed renal dysplasia and his symptoms resolved with the administration of IV calcium...
July 2006: Pediatric Emergency Care
Timothy R Myers
For over 70 years, helium-oxygen mixture (heliox) has been promoted as adjunctive therapy to overcome airflow-obstructive disorders and lesions. In the past 2 decades heliox has gained widespread support in many pediatric emergency departments and intensive care units, in treatment of infants and children with both upper and lower airway obstruction. Because heliox is less dense than air or oxygen, it provides more laminar flow in obstructed airways, and it is purported to reduce work of breathing, respiratory distress, and postextubation stridor...
June 2006: Respiratory Care
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