Common Causes of Respiratory Distress Cause

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

306

Pages:

5
Author:

Mariam A. A.

Common Causes of Respiratory Distress Cause Description Hyper-responsive airways Bronchi constriction and secrete mucus Narrowed airways -> wheeze High pitched sound heard on expiration Asthma Prolonged expiration phase Wheeze is not pathognomonic E.g. viruses can bring a few days of wheeziness Small children are better with a face mask attached to spacer, so they don’t have to cooperate with putting their mouth around the mouthpiece Viral infection of the upper airways Commonest in toddlers Makes them miserable with fever Inflammation of the airways -> characteristic barking cough and hoarse voice Turbulent airflow -> stridor May be inspiratory or expiratory Harsh sounds Lower as the narrowing gets worse Gets worse it the force of the air through the narrowed airway increases E.g. when crying Other signs Intercostal recession Subcoastal recession Croup Sternal recession Tracheal tug Breathing though obstruction -> causes fatigue -> respiratory failure Fatigue -> less respiratory effort -> stridor becomes softer Responds well to steroids Oral dexamethasone Prednisolone Nebulised budesonide In severe croup Nebulised adrenaline for a more immediate effect Does not cure croup But buys time by shrinking the inflamed airways while waiting for steroids to work Hence may need to be repeated Infants aged 1 month to 1 years old Features: Shortness of breath Wheezing Wheezy cough and runny nose Sometimes mild temperature Main cause -> RSV Infect lower airways -> secretions Examination features: Bronchiolitis Wet cough Wheeze Tunny nose Temperature More commonly in winter Illness progression -> infant becomes tired -> not enough energy to feed properly No specific treatment in children May need to be admitted for oxygen if they come hypoxic or for feeding support it is feeding inadequately or for respiratory support in severe cases Most infections in children are self-limiting Most infections are pneumonia A few may have a bacteria pneumonia Children under 3 years: Signs of sepsis CXR, as clinical features are very subtle Clinical presentations Appear unwell More lethargic than common viral infections Temperature more than 38.5 Often refuse food and drink Noisy breathing Accessory muscle use Subcostal recession Pneumonia Tachypnoea Cough Unlike adults, this is a less reliable symptom in children Auscultation As chest is small and sounds transmit all over Hence focal sounds are harder to detect Diagnosis Have to rely on general signs f severe infections due to above reasons Can be picked up by the 3 minute toolkit Lethargy Fever High heartrate The most important discrimination sign when examining the respiratory system is a raise respiratory rate Low oxygen saturations also give a clue to pneumonia