Peds O- Oxygen, Airway, and Respiratory Disorders
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 14 January 2018
⏱️ 10 minutes
🧾️ Download transcript
Summary
Applying oxygen is one of the first steps in treating any crashing child!!!
Airway Emergencies
* Foreign body (FB)* Patient presentation* Stridor* Choking episode* Testing* CXR* May directly show foreign body* May show secondary effects of a foreign body* Hyperinflated/collapsed lobes of the lung* Patient needs bronchoscopy if suspicion is high* Peritonsillar abscess* Visible in the pharynx* Bacterial tracheitis* HIDDEN IN the airway* Epiglottitis* HIDDEN ABOVE the airway* Retropharyngeal abscess* HIDDEN BEHIND behind the airway* Common presentations of airway emergencies* Voice changes* Drooling* Stiff neck* Testing* Most are seen on neck X-Ray* Peritonsillar abscess is clinical diagnosis* Treatment* Manage the airway* IV Antibiotics * Peritonsillar abscess needs drainage
Breathing Emergencies
* Bronchiolitis = Badly breathing booger babies* Upper respiratory infection caused by virus* Signs of severe illness requiring admission* Grunting* Nasal flaring* Retractions* Hypoxemia* Unable to tolerate PO* Treatment* Deep suctioning* Can consider albuterol trial* Oxygen supplementation as needed* Generally avoid* Chest X-rays* Steroids* Antibiotics* Asthma* Treatment* First line* Albuterol/ipratropium* Steroids* Additional options as needed* Magnesium* Ketamine* IV epinepherine* Croup* Presentation* Barky cough* Stridor* Treatment* Steroids* Consider racemic epinephrine* Pneumonia* Diagnosed by x-ray* Treat with antibiotics* Cystic fibrosis* Albuterol/ipratropium* Nebulized saline* Antibiotics
Additional Reading
* Approach to Asthma (EM Clerkship)* More Than a Sore Throat (emDOCs)
Transcript
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| 0:00.0 | Hello, med students. My name is Zach Olson, and thank you for downloading this week's episode of the EM Clerkship Podcast. |
| 0:11.9 | Here's our case. |
| 0:18.3 | Okay, everybody, this is Dakota. He's a three and a half year old male is awoken with diffuse abdominal pain |
| 0:23.6 | According to mom he vominated about five times some of that was productive |
| 0:27.6 | Um has a rash on the anterior chest he was lethargic when we got there since we've been there with him and through the transport now crying as you can see |
| 0:36.6 | Lone sounds were clear as far as we can tell. |
| 0:39.0 | We then noticed O2 sats dropping and had cyanosis around the lips. So he put him on O2. He's, |
| 0:45.5 | he had no previous fever, now 102.3 rectal. Mom and extended family are out here, so just FYI. |
| 0:53.3 | GCS at 10, BP 100 over 60. |
| 0:56.0 | Pulsal 12, 997% on the O2, and no allergies, no meds had not been sick for the past couple days. |
| 1:03.0 | Any questions? |
| 1:04.0 | Anybody, I know it was a lot. |
| 1:05.0 | He's kind of crunking on us. |
| 1:07.0 | Okay? |
| 1:08.0 | Thank you. |
| 1:10.0 | All right. Same case as last week. We've already talked about general |
| 1:17.8 | peds. We've talked about peds exam. And last week, we stepped it up a few levels and kicked |
| 1:23.6 | off our series on the approach to a sick child. When everybody's sphincters are tight and something is wrong with a pediatric patient, |
| 1:32.7 | fall back on your mnemonic. |
| 1:35.1 | Oh shit. |
| 1:36.5 | Grab the brazlo. |
| 1:37.8 | And we're going step by step through this, starting this week with the O. |
... |
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