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laryngitis (croup)
laryngeal dyspnea, most common in young children, wake up having trouble breathing
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clinical presentation of laryngitis
increasing stridor(high pitched sound), barking cough
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tx of laryngitis
- o2, nebulized racemic epinephrine alpha (vasocontr and dec subglottic edema)and beta (bronchodilation)
- and dexa 0.6mg/kg oral or IM x one dose after discharge
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epiglottis def
rapid, progressive inflammation of epiglottis
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etiology of epiglottis
H inf type b
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clinical presentation of epiglottis
rapid onset, respiratory distress, tripod position, drooling, dysphagia, dysphonia, fever
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tx of epiglottitis
- establish airway-usually in operating room
- abx therapy for H inf type b
- -cefuroxime 150mg/kg/d q 8 h
- -cefotaxime 150-200 mg/kg/d 1 6 h
- -ceftriaxone 100 mg/kg/d q 12 h
- treat for 10 day
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early onset neonatal sepsis
- 7 d
- Group B strep
- Gm - enterics
- list mono
-
late onset neonatal sepsis
nonhosp
- 7-30 d
- group b strep
- gm - enterics
- list mono
-
late onset neonatal sepsis
hosp
- group b step
- gm - enterics
- list mono
- staph aur
- staph epid
- pseudo aeru
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pts older than 1 month of age-organisms
- strep pneu
- hae inf-Type B
- neiss menin
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clinical presntation of sepsis and mening
- ha, fever, stiff neck
- fontanelles allow pressure so no stiff neck, rather
- feeding difficulty, irritability, apnea, temp instability
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tx for early onset neonatal sepsis
- amp + gent
- or
- amp + cefotaxime
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tx late onset neonatal sepsis nonhosp
- amp + gent
- amp + cefotaxime, same as early
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tx late onset neonatal sepsis hosp
- vanco + gent
- or
- vanco + cefotaxime
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tx for pts older than 1 month
- ceftriaxone + vanco
- **consider dexa if pt is >2mo old, b4 or w 1st dose of abx, prevents compications and hearing loss
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