Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
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Child with stridor<br />
Stridor is a harsh vibrating sound originating from the large upper airways and occurring on inspiration. It occurs due to upper airway<br />
obstruction. Consider the following causes: croup – common, inhaled foreign body, epiglottitis – rare but important, trauma, angioneurotic<br />
oedema, mass (tumour or abscess)<br />
Obtain full history, including Hib immunisation status. Limit examination. Do not examine mouth or throat<br />
Consult MO<br />
In the meantime, consider epiglottitis<br />
Yes<br />
Significant features of assessment unclear or you are unsure of cause?<br />
No<br />
Gradual swelling of face,<br />
neck and throat<br />
Sudden onset in previously<br />
well child<br />
Slow onset<br />
Rapid onset<br />
Usually there is a history<br />
of exposure to allergen: an<br />
injection of a drug or blood<br />
product, ingestion of oral drug<br />
/ food or bites / stings<br />
Cough or wheeze may be<br />
present<br />
Usually there is a history<br />
of ingesting or choking on<br />
something e.g. peanut<br />
Croupy (barking) cough<br />
Temp < 38.5°C<br />
No systemic disturbance<br />
Severe stridor less common<br />
Able to swallow<br />
Will usually drink<br />
Normal voice<br />
< 4 years<br />
More prominent at night<br />
Weak or no cough<br />
Temp >38.5°C<br />
Septicaemia<br />
Drooling saliva<br />
Unable to eat or drink<br />
Doesn’t talk<br />
Any age<br />
Reluctant to move neck<br />
As the condition<br />
deteriorates the stridor<br />
may decrease<br />
Paediatric presentation<br />
Child with stridor<br />
See<br />
Anaphylaxis<br />
See<br />
Acute upper airway<br />
obstruction / choking<br />
See<br />
Croup / epiglottitis<br />
See<br />
Croup / epiglottitis<br />
Primary Clinical Care Manual 2011 Controlled copy V 1.0 555
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