Pediatric Upper Airway Infectious Disease Emergencies
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Pediatric Upper Airway Infectious Disease Emergencies

November 2007

Abstract

Pediatric respiratory emergencies are commonly seen in the emergency department. They can range from mild to severe and, at times, require life-saving interventions to prevent complete airway obstruction and respiratory arrest. Every emergency physician must be able to recognize, assess, stabilize, and manage a pediatric patient with respiratory distress. The presentation of a child in respiratory distress due to an upper airway infection may consist of fever, difficulty breathing, noisy breathing, irritability, and/or dehydration.

A number of changes have begun to take place in the management of these illnesses. Historically, humidified mist was used as initial therapy for children with croup, although its effectiveness was never proven. Recent studies have confirmed no benefit from this therapy.13,14 Retropharyngeal and peritonsillar abscesses, previously thought to be amenable only to surgical drainage, have now been shown to respond to aggressive medical therapy alone in certain cases.15-19 Finally, ultrasound as an imaging tool for use in the evaluation of upper airway pathology20-24 may provide a less costly and more rapid option for diagnosis that does not cause radiation exposure (to which developing children are particularly sensitive).
 

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