REBEL Core Cast β Pediatric Respiratory Emergencies: Beyond Viral Season
Welcome to the Rebel Core Content Blog, where we delve ...

REBEL Cast
Welcome to the Rebel Core Content Blog, where we delve into crucial knowledge for emergency medicine. Today, we share insightful tips from PEM specialist Dr. Elise Perelman, shedding light on respiratory challenges in infants, toddlers, and young children during the viral season. Understanding that most cases involve typical viruses, we aim to equip you with diagnostic pearls to identify more serious pathologies.
Pearl #1: Look at Your Patient
Begin exams from the doorway. Observing patterns such as accessory muscle usage can reveal a patientβs respiratory effort. Specify whether the work of breathing occurs during inspiration, expiration, or both. Inspiratory work indicates difficulty getting air in, while expiratory work suggests trouble pushing air out. Silent tachypnea may point to other issues, like acidemia or pneumothorax.
Pearl #2: Localize the Sound
Breathing noises signal varied respiratory issues. Stridor, often heard on inspiration, results from obstructions above the thoracic inlet. Conversely, wheezing, generally linked to exhalation, indicates obstructions in the lower airways. Watch for signs like βsilent chestββa dangerous, severe obstruction, and distinguish grunting as a bodily mechanism to prevent alveolar collapse. Correctly identifying the sound assists in determining the appropriate intervention.
Once a sound is localized, treatments vary. We explore Soder from nasal congestion, typically needing supportive care and suctioning. Stridor from conditions like croup is eased with interventions to reduce airway swelling, such as steroids or inhaled epinephrine. Conversely, wheezing in infants is often due to bronchiolitisβnot bronchospasmsβand over-treatment is to be avoided. Supportive measures including suction, hydration, and oxygen are preferred unless improvement warrants bronchodilators.
In severe cases of asthma or bronchiolitis, where standard at-home treatments fail, immediate adjunct therapies like intramuscular epinephrine become essential. Administering this quickly can alleviate obstruction when inhalants arenβt effective due to low air movement.
When recognizing Zebrasβuncommon cases overshadowed by routine diagnosesβremain vigilant for histories or presentations that donβt conform. Conditions like pneumonia, bacterial tracheitis, and even myocarditis may mimic more common issues.
As attending physicians, our role extends beyond conventional treatmentβitβs about discerning the atypical from the typical. Dr. Perelman urges continual reassessment, emphasizing reliance on observational skills as much as technological aid. Keeping keen on respiratory nuances ensures we catch those outlier cases, paving the way for adept medical care despite the overwhelming prevalence of viral infections.
Stay tuned for more pearls and insights in our future posts, as Dr. Perelman shares further strategies for effective pediatric emergency care. For more resources, continue exploring our facultyβs valuable contributions on our site. Until then, stay safe and perceptive in your practice.
Post Peer Reviewed By: Mark Ramzy, DO (X: @MRamzyDO), and Marco Propersi, DO (X: @Marco_Propersi)
Pediatric Emergency Medicineβ Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Welcome to the Rebel Core Content Blog, where we delve ...
Host Dr. Mark Ramzy shines a spotlight on three distinguished ...
The QT interval is a vital part of ECG interpretation, ...
π§ REBEL Rundown πIntroduction In this exciting episode of REBEL ...
Managing diabetic ketoacidosis (DKA) requires careful consideration of fluid therapy, ...
The post REBEL Core Cast β Pediatric Respiratory Emergencies: Beyond Viral Season appeared first on REBEL EM - Emergency Medicine Blog.
