There are important respiratory disorders which are very common amongst patients with respiratory diseases. Such disorders call for great concern. What are they?
Viral coup syndrome
Viral coup syndrome is the inflammation of larynx, trachea, and bronchial tubes that takes different progressive forms presenting a syndrome of laryngeal obstruction (edema of the subglottic region leads to narrowing of the airway). It can be Acute Laryngotracheitis or Laryngotracheobronchitis or spasmodic croup (more abrupt onset, milder course).
Viral coup syndrome is caused by a viral infection in the subglotic area of the larynx transmitted. Most cases involve children age 3 months to 3 years. Peak incidence of the disease is in late autumn, early winter.
• Often occurring at night
• Croupy (barky) cough
• Inspiratory dyspnea
• Coryzea (catarrh)
• Intercostals, suprasternal, infrasternal retractions.
• Respiratory rate slightly increased.
• Open a window for cool night air.
• Humidified air (mist therapy).
• Placed mustard plaster on gastrocnemius muscle or mustard warm footbath.
• Inhalations with adrenaline.
• Oxygen therapy added if hypoxemia present
• Corticosteriods therapy
• Requires hospitalization
FOREIGN BODY ASPIRATION
Foreign body aspiration is the aspiration of small objects (seeds, nuts, toy parts, buttons, pebbles) into the laryngotracheal or main stem bronchus. Aspiration is frequent in children between 7 months and 4 years.
Signs and symptoms depend on degree that child was swallowing or playing with a small object followed by sudden onset of cough. Choking or gagging or wheezing.
There may be a period of no symptoms following initial episode. Laryngeal foreign bodies may completely obstruct airways and may elicit stridor, high pitched wheezing, cough or aphonia and cyanosis. Tracheal foreign bodies usually elicit cough, some stridor or wheezing and may produce “slap” sound.
Bronchial foreign bodies usually cause wheezing or coughing and are frequently misdiagnosed as asthma; may present with decreased vocal fremitis, impair or hyper-resonant percussion note, and diminishes breath sounds distal to foreign body.
1. Upper airway foreign bodies may be visualized on standard roentgenography.
2. Bronchoscopy is usually required for definitive diagnosis or foreign bodies in the larynx and trachea.
1. Establish airway if child is in obvious distress
2. Back flows, Heimlich maneuver
3. Removed by means of direct laryngoscopy or bronchoscopy
4. prevention is most important aspect; age appropriate anti-cipatory guidance, including siblings.
Lung hemorrhage is very dangerous condition because the blood from the lungs doesn’t clot.
• Cough with blood parts in mucus
• Profuse bleeding (bright-red colored blood with air bubbles).
• During auscultation; moist rales;
• Paleness of skin
• Rapid decrease of blood pressure
1. Ask child to stay in half-sitting position quietly
2. provide measures to decrease blood pressure in lung circulation
• tie tourniquet on lower extremities
• administer 2.4% solution of euphillini (dosage 3-5mg/kg).
3. Make hemostatic treatment.
RESPIRATORY SYSTEM DISORDER SYNDROMES
1. Syndrome of consolidation or compression of the lung tissue.
2. syndrome of broncho-obstruction
3. syndrome of respiratory failure
4. syndrome of atelectasis.
5. syndrome of pneumothorax.
6. Syndrome of liquid in the plural cavity
7. syndrome of laryngotracheitis
8. syndrome of bronchitis
9. syndrome of congenital stridor
10. syndrome of cough
11. Pain syndrome.
12. Syndrome of intoxication
13. syndrome of bronchial hemorrhage
14. syndrome of bronchial hemorrhage
15. syndrome of acute inflammation of the respiratory tract mucous.
Don’t be scared of the big names here, they will not take you to hell. Most of them are simple clinical cases that can be easily handled.