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approach to a chid with wheezing
This document discusses acute respiratory infections, focusing on acute bronchiolitis. It defines acute respiratory infections as infections of the respiratory tract from the nostrils to the alveoli. It then classifies infections as either upper respiratory tract infections like rhinitis, laryngitis, or pharyngitis, or lower respiratory tract infections like pneumonia or bronchitis. The document goes on to discuss acute bronchiolitis specifically, noting that it is a common disease in infancy caused by viruses like RSV that results in inflammatory obstruction of the smaller airways, with symptoms like wheezing, respiratory distress, and cough. Treatment focuses on supportive measures like humidified oxygen, positioning, maintaining hydration, and nebulized bronch
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Introduces Acute Respiratory Infections, defining them as infections affecting the respiratory tract from nostrils to alveoli.
Categorizes infections into upper respiratory tract (e.g., Rhinitis, Pharyngitis) and lower (e.g., Pneumonia, Bronchitis).
Discusses wheezing, its causes, diagnostic approach, symptoms, and considerations in assessing respiratory distress.
Focuses on Acute Bronchiolitis, a common condition in infants characterized by inflammation and obstruction of airways.
Identifies the main causative agents like RSV, at-risk age groups (1-6 months), and contributing factors such as overcrowding.
Outlines initial symptoms like cough and fever, and examination findings including tachypnea and chest retractions.
Details investigation methods (CXR) and distinguishes other conditions like asthma, foreign body inhalation.
Presents treatment steps including hospitalization, oxygen therapy, positioning, hydration, and medications like bronchodilators.
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approach to a chid with wheezing
- 1. ACUTE RESPIRATORY INFECTIONS DrShambhavi Sharma
- 2. Definition acute infection ofthe respiratory tract from nostrils to alveoli
- 3. Classification Acute upperrespiratory tract infections: Rhinitis Laryngitis Acute epiglottis Pharyngitis Croup Otitis media tracheitis Lower respiratory tract infections: Pneumonia Bronchiolitis Bronchitis Bronchial asthma
- 4. Approach to awheezing child
- 5. Wheezing Wheezing occursdue to rapid passage of air through narrowed airways High-pitched, musical, adventitious sound
- 6. Causes of wheezing Asthma Infections Bronchiolitis Pneumonia Bronchitis GER Tropical pulmonary eosinophilia Foreign body aspiration CHF Cystic fibrosis Mediastinal masses Tracheobronchial anomalies Congenital vascular abnormalities
- 7. Approach Age atonset Pattern Episodic/persistent Seasonality Relation to feeding Onset Cough Relation with position Past history Family history
- 8. Approach Respiratory distress:nasal flaring, grunting, retractions ?audible without stethoscope Nutritional status Detailed resp examination
- 9.
- 10. Acute Bronchiolitis Commondisease in infancy Inflammatory obstruction of smaller airways
- 11. Etiology RSV (>50%) Parainfluenzae 3, 1, 2 Influenza Adeno Mycoplasma pneumoniae
- 12. Age group:1-6 months predominantly < 2yrs Winter & early spring Male Babies without breast feeding Overcrowding
- 13. Clinical Features Initially:mild URTI Sneezing, rhinorhea Fever Resp. distress Cough Dyspnea Chest retractions Irritability Cyanosis
- 14. Examination Tachypnea Chestretractions Hyperinflation Wheeze Prolonged expiration P/A Liver, spleen: pushed down
- 15. Investigation CXR Hyperinflation TLC/ DLC Usually normal
- 17. D/D Asthma Bronchopneumonia Foreign body inhalation CHF Tracheomalacia
- 18. Treatment Patient withresp. distress hospitalization Cool humidified Oxygen Positioning Sitting with head & chest elevated at 300 with neck extended NPO Maintain hydration
- 19. Treatment Bronchodilators NebulizedAdrenaline Nebulized β2 agonists Hypertonic saline (3%) nebulization Corticosteroid: ?? Role Antiviral: RIBAVARIN Aerosolized Esp indicated for infants with CHD CLD