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Croup and Airway Obstruction
Prereading :

CHQ Croup Guideline
File Size: 353 kb
File Type: pdf
Download File


Workbook Cases :

Case 1
A 3-year-old boy presents with sudden onset barking cough overnight. He seemed to have very noisy breathing at home but this has settled prior to presentation. He now examines well with no work of breathing but still has an intermittent barking cough.
  1. How would you treat him?
  2. How long does he need to stay in the emergency department? What advice will you give to his parents on discharge?
 
Case 2
A 2-year-old girl presents with her father with loud stridor and associated increased work of breathing. She was well before she went to bed but woke up suddenly with a barking cough and significant stridor. On examination, she is febrile, has moderate to severe tracheal tug and subcostal recessions with loud stridor.  Her RR is 40 and Sats are 96%
 
  1. What is your immediate management?
  2. Following this management, she responds well.  How long should she stay in the department and what would your discharge criteria be? 
  3. If she had no improvement after the initial management, how would you escalate your management?
  4. If she was unimmunized how would this change your management?
 
Case 3
A 4-year-old boy was playing with a coin when he accidentally inhaled it and started choking. After coughing for a few minutes, he had a colour change around his lips. On arrival to ED he was sitting up and drooling with soft stridor.
 
  1. What are your concerns with the above presentation? What would be your management priorities?
  2. Imaging reveals a $1 coin in the upper airway, what are the next steps you would take? 

Case 4
A 12-year-old female who is allergic to peanuts was at a friend’s house eating banana bread when suddenly she felt a tightness in her throat. She tried taking 10mg cetirizine but started vomiting. Her friend’s mum drove her to ED. On arrival, her obs are HR 120, RR 30, Sats 92% and BP 88/64.  She has a hoarse voice and global wheeze and appears to be quite pale.
 
  1. What is the first management step including the dose and route of administration?
  2. As well as the initial drug are there any other medications you would deliver?
  3. How long would you keep her in the department for?
  4. Where can you find discharge information on anaphylaxis and how will you prescribe an epi pen?
Copyright © 2015
  • Home
  • Guidelines
    • AAA Rupture
    • Acute Coronary Syndrome
    • Anaphylaxis
    • Aortic Dissection
    • Appendicitis
    • Asthma
    • Backpain
    • Bowel Obstruction
    • Bronchiectasis
    • Burns
    • Chest Pain >
      • ADP Chest Pain Pathway
    • Cholecystitis
    • Confusion
    • COPD
    • Diverticulitis
    • DKA
    • DVT
    • Eating Disorders
    • Febrile Neutropaenia
    • Fractures >
      • Bier's block procedure form
      • Fractured neck of Femur
    • Funnel Web Spider Bite
    • Headache
    • Influenza Like illness
    • Meningitis
    • Obstetrics >
      • Hypertensive disorders in pregnancy
      • Normal Birth
      • PPH
      • Preterm labour
      • Still birth
      • Trauma in pregnancy
    • Pancreatitis
    • Paracetamol OD
    • Pathology Ordering
    • Peri-anal abscess
    • Pertussis
    • Pneumonia
    • Pneumothorax
    • Podiatry
    • Procedural Sedation >
      • Procedural Sedation
    • Pulmonary Embolus
    • PV Bleeding in Early pregnancy >
      • EPAU - Early Pregnancy Assessment Unit
    • Redback Spider Bite
    • Ring cutter use
    • Seizure
    • Septic Arthritis
    • Use of Restraints
    • Stroke / TIA
    • Sepsis
    • Smoking cessation
    • Snake Bite
    • Syncope >
      • Telemetry guideline
    • TIA
    • Tonometer use
    • Antidotes
    • Dagibatran reversal guidelines
    • Funnel Web Spider Bite
    • Redback Spider Bite
    • Paracetamol OD
    • Snake Bite
    • Warfarin Reversal Guidelines
    • Trauma >
      • C-spine injury
      • Head Injury
      • Imaging Guidelines
      • Trauma in pregnancy
      • Sutures
    • Abdominal Pain
    • Allergy / Anaphylaxis
    • Antimicrobial Guidelines
    • Asthma & Wheeze
    • Behavioural Disturbance
    • Boils - Staph decolonisation treatment
    • Bronchiolitis
    • Buckle fractures
    • Burns
    • Cervical Spine Guideline
    • Chest Pain (Paediatric)
    • Child Protection
    • Constipation
    • Croup
    • DKA
    • Drowning
    • Eating Disorders
    • Fever
    • Fluids in Kids
    • Foreign Bodies
    • Gastroenteritis
    • Headache
    • Head Injury
    • High Flow Nasal Cannula Oxygen
    • Hypoglycaemia
    • Jaundiced Neonate
    • Limping in children
    • Malaria
    • Meningitis
    • Oncology Emergencies
    • Otitis Externa
    • Otitis Media
    • Paediatric Fracture Clinic Referral
    • Paracetamol Poisoning
    • Petechial Rash
    • Pneumonia (CAP)
    • Seizures / Status Epilepticus
    • Sepsis Guideline
    • Tetanus Prophylaxis
    • Torticollis
    • UTI NICE Guideline
    • Trauma in children >
      • LCCH Paeds Trauma Guidelines
      • C Spine Injury LCCH Guideline
      • LCCH Massive Transfusion
    • RCH Melbourne Guidelines
  • Parent Handouts
    • Accidental Poisoning
    • Abdominal Pain
    • Ankle Sprain
    • Arrhythmia
    • Asthma
    • Bronchiolitis
    • Chest Infections
    • Cast Care
    • Cellulitis
    • Constipation
    • Croup
    • DKA
    • Epistaxis
    • Eye Foreign Body
    • Febrile Convulsion
    • Fever
    • Fracture- Buckle
    • Fracture- Clavicle
    • Fracture- Elbow
    • Fracture- Finger/Toe
    • Fracture- Foot
    • Gatroenteritis
    • Glue- Lacerations
    • Head Injury
    • Jaundice
    • Otitis Externa
    • Parechovirus
    • Periorbital and Orbital cellulitis
    • Pulled Elbow
    • Seizures
    • Tonsillitis
    • Urticaria
    • Viral Illness
    • Wound Care
  • ACE the ACEM
  • Blog