Managing Respiratory Emergencies Flashcards

A 4-year-old child presents with a sudden onset of high fever, muffled voice, drooling, and is sitting in a 'tripod' position. Which of the following respiratory emergencies is most likely?

Answer: Epiglottitis

The classic signs of epiglottitis are the '4 Ds': dysphagia (difficulty swallowing), dysphonia (muffled voice), drooling, and distress. The child often assumes a tripod position to maximize air entry. This is a life-threatening upper airway emergency.

During the initial assessment of an infant, you observe nasal flaring, grunting, and significant subcostal retractions. These are signs of which type of respiratory problem?

Answer: Respiratory failure

Grunting is an ominous sign indicating the child is trying to maintain positive end-expiratory pressure to keep alveoli open. Combined with significant retractions and nasal flaring, these findings point towards respiratory failure, where the body can no longer compensate.

Which of the following is the most appropriate initial intervention for a child with lower airway obstruction, such as asthma, who is in moderate respiratory distress?

Answer: Administering a nebulized bronchodilator

Lower airway obstruction, commonly seen in asthma and bronchiolitis, involves bronchoconstriction. A nebulized bronchodilator like albuterol is a first-line treatment to open the airways and improve air exchange.

A 2-year-old is brought in after being found with a small toy in their mouth. The child is now unable to speak or cough effectively and has stridor. What is the immediate priority in managing this patient?

Answer: Deliver age-appropriate back blows and chest thrusts.

For a conscious child with a severe foreign-body airway obstruction (indicated by ineffective cough and stridor), the recommended intervention is to deliver repeated cycles of back blows and chest/abdominal thrusts until the object is expelled or the child becomes unresponsive.

A 6-month-old infant presents with a runny nose, cough, and rapid, shallow breathing for two days. On examination, you hear widespread crackles and wheezing. This clinical picture is most consistent with which condition?

Answer: Lung tissue disease (e.g., bronchiolitis)

Bronchiolitis, a common lung tissue disease in infants, is characterized by inflammation of the small airways (bronchioles). This leads to symptoms like a preceding upper respiratory infection, tachypnea, and auscultatory findings of wheezing and crackles.

In the PEARS systematic approach, which category of respiratory problem would be suspected in a child with an irregular breathing pattern, variable respiratory effort, and a known recent head injury?

Answer: Disordered control of breathing

Disordered control of breathing is characterized by an abnormal respiratory pattern due to a problem outside the lungs, such as a neurologic issue (e.g., increased intracranial pressure from a head injury), poisoning, or metabolic disturbance. The lungs themselves may be healthy.