4. Croup & Epiglottitis

what is croup?

inflammation and edema of the larynx, trachea, and bronchi from a viral infection (usually parainfluenza)

what usually causes croup?

viral infection, parainfluenza

when do croup symptoms usually occur?

suddenly, most often at night

what causes airway obstruction in croup?

inflammation and edema of the upper airway, worsened by mucus production

what are the symptoms of croup?

• inspiratory stridor and hoarseness

• barking cough

• fever may be present

which medications treat croup?

corticosteroids and racemic epinephrine (inhaled epinephrine)

what should caregivers know about home management of croup?

• symptoms of respiratory distress

• when to seek medical attention

• expose child to humidified air

• medication administration and monitoring

how do croup and epiglottitis differ?

• croup: no drooling, can lie down, cough

• epiglottitis: cough usually absent, drooling, tripod sitting

epiglottitis is a _____ *

medical emergency !!!!

why is epiglottitis a medical emergency?

the airway can rapidly become COMPLETELY occluded

what usually causes epiglottitis?

haemophilus influenzae type B (Hib) (bacterium)

what findings suggest epiglottitis?

• sudden onset of high fever and toxic appearance

• refusal to speak or very soft voice

• refusal to lie down, may sit forward with neck extended (tripod position)

• drooling (can’t swallow)

• anxiety/frightened appearance

• cough usually absent

• stridor

what is the priority treatment for epiglottitis?

airway management

coughing is usually _____ in epiglottitis

absent

treatment for _____ treats epiglottitis?

antibiotics, started as soon as possible

what must the nurse avoid with suspected epiglottitis? *

• NO attempting to visualize the throat

• NO placing the child supine

• NO leaving the child unattended

how should the nurse keep a child with epiglottitis calm? *

allow a position of comfort and let the caregiver hold the child

can the nurse assess RR in a child with epiglottitis?

yes—observe respirations while keeping the child calm

how should oxygen be provided for epiglottitis?

100% oxygen in the least invasive manner acceptable to the child

what equipment must be at the bedside for epiglottitis? *

emergency airway and rescue equipment