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Podcast 886: Cough in Kids

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Contributor: Ricky Dhaliwal, MD

Educational Pearls:

Croup

  • Caused by:

    • Parainfluenza, Adenovirus, RSV, Enterovirus (big right now)

  • Age range:

    • 6 months to 3 years

  • Symptoms:

    • Barky cough

    • Inspiratory stridor (Severe = stidor at rest)

    • Use the Westley Croup Score to gauge the severity

  • Treatment:

    • High flow, humidified, cool oxygen

    • Dexamethasone 0.6 mg/kg oral, max 16mg

    • Severe: Racemic Epinephrine 0.5 mL/kg

    • Consider heliox, a mixture of helium and oxygen

    • Very severe: be ready to intubate

Bronchiolitis

  • Caused by:

  • RSV, Rhinovirus

  • Symptoms are driven by secretions

  • Symptoms:

    • Cough

    • Wheezing

    • Dehydration (often the symptom that makes them look the worst)

  • Age range:

    • 2 to 6 months

  • Treatment:

    • Suctioning

    • Oxygen

    • IV fluids

    • Nebulized hypertonic saline

    • DuoNebs? No.

Asthma

  • Caused by:

    • Environmental factors

    • Viral illness with a predisposition

  • Treatment:

    • Beta agonists

    • Steroids

    • Ipratropium

    • Magnesium (relaxes smooth muscle)

References

  • Dalziel SR, Haskell L, O'Brien S, Borland ML, Plint AC, Babl FE, Oakley E. Bronchiolitis. Lancet. 2022 Jul 30;400(10349):392-406. doi: 10.1016/S0140-6736(22)01016-9. Epub 2022 Jul 1. PMID: 35785792.

  • Hoch HE, Houin PR, Stillwell PC. Asthma in Children: A Brief Review for Primary Care Providers. Pediatr Ann. 2019 Mar 1;48(3):e103-e109. doi: 10.3928/19382359-20190219-01. PMID: 30874817.

  • Midulla F, Petrarca L, Frassanito A, Di Mattia G, Zicari AM, Nenna R. Bronchiolitis clinics and medical treatment. Minerva Pediatr. 2018 Dec;70(6):600-611. doi: 10.23736/S0026-4946.18.05334-3. Epub 2018 Oct 18. PMID: 30334624.

  • Smith DK, McDermott AJ, Sullivan JF. Croup: Diagnosis and Management. Am Fam Physician. 2018 May 1;97(9):575-580. PMID: 29763253.

  • Westley CR, Cotton EK, Brooks JG. Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study. Am J Dis Child. 1978 May;132(5):484-7. doi: 10.1001/archpedi.1978.02120300044008. PMID: 347921.

  • https://www.mdcalc.com/calc/677/westley-croup-score

Summarized by Jeffrey Olson | Edited by Meg Joyce & Jorge Chalit, OMSII

  continue reading

1058 episodes

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Podcast 886: Cough in Kids

Emergency Medical Minute

539 subscribers

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Fetch error

Hmmm there seems to be a problem fetching this series right now. Last successful fetch was on June 17, 2024 11:34 (3d ago)

What now? This series will be checked again in the next day. If you believe it should be working, please verify the publisher's feed link below is valid and includes actual episode links. You can contact support to request the feed be immediately fetched.

Manage episode 395494009 series 1397179
Content provided by medicalminute and Emergency Medical Minute. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by medicalminute and Emergency Medical Minute or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.

Contributor: Ricky Dhaliwal, MD

Educational Pearls:

Croup

  • Caused by:

    • Parainfluenza, Adenovirus, RSV, Enterovirus (big right now)

  • Age range:

    • 6 months to 3 years

  • Symptoms:

    • Barky cough

    • Inspiratory stridor (Severe = stidor at rest)

    • Use the Westley Croup Score to gauge the severity

  • Treatment:

    • High flow, humidified, cool oxygen

    • Dexamethasone 0.6 mg/kg oral, max 16mg

    • Severe: Racemic Epinephrine 0.5 mL/kg

    • Consider heliox, a mixture of helium and oxygen

    • Very severe: be ready to intubate

Bronchiolitis

  • Caused by:

  • RSV, Rhinovirus

  • Symptoms are driven by secretions

  • Symptoms:

    • Cough

    • Wheezing

    • Dehydration (often the symptom that makes them look the worst)

  • Age range:

    • 2 to 6 months

  • Treatment:

    • Suctioning

    • Oxygen

    • IV fluids

    • Nebulized hypertonic saline

    • DuoNebs? No.

Asthma

  • Caused by:

    • Environmental factors

    • Viral illness with a predisposition

  • Treatment:

    • Beta agonists

    • Steroids

    • Ipratropium

    • Magnesium (relaxes smooth muscle)

References

  • Dalziel SR, Haskell L, O'Brien S, Borland ML, Plint AC, Babl FE, Oakley E. Bronchiolitis. Lancet. 2022 Jul 30;400(10349):392-406. doi: 10.1016/S0140-6736(22)01016-9. Epub 2022 Jul 1. PMID: 35785792.

  • Hoch HE, Houin PR, Stillwell PC. Asthma in Children: A Brief Review for Primary Care Providers. Pediatr Ann. 2019 Mar 1;48(3):e103-e109. doi: 10.3928/19382359-20190219-01. PMID: 30874817.

  • Midulla F, Petrarca L, Frassanito A, Di Mattia G, Zicari AM, Nenna R. Bronchiolitis clinics and medical treatment. Minerva Pediatr. 2018 Dec;70(6):600-611. doi: 10.23736/S0026-4946.18.05334-3. Epub 2018 Oct 18. PMID: 30334624.

  • Smith DK, McDermott AJ, Sullivan JF. Croup: Diagnosis and Management. Am Fam Physician. 2018 May 1;97(9):575-580. PMID: 29763253.

  • Westley CR, Cotton EK, Brooks JG. Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study. Am J Dis Child. 1978 May;132(5):484-7. doi: 10.1001/archpedi.1978.02120300044008. PMID: 347921.

  • https://www.mdcalc.com/calc/677/westley-croup-score

Summarized by Jeffrey Olson | Edited by Meg Joyce & Jorge Chalit, OMSII

  continue reading

1058 episodes

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