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Croup
Assess Croup Score
1 Croup
7
OPD
Supportive treatment
Admit Ward Admit ICU
Dexamethasone 0.6 ./. IV/IM
Epinephrine (1 : 1000) 0.05 -0.5 ./. nebulized
(< 4 : 2.5 .)
Observe 24
epinephrine
30 3 monitor HBP
Intubation*
* : increased retractions, decreased air entry,
worseningstridor, decreased stridor but increased wheeze, cyanosis,
depressed sensorium, hypoxia, hypercarbia
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Wheezing child
nebulized beta 2 agonist
10 -15
Rx as asthma
try 2nd dose
bronchodilator 10-15
Dx Acute Bronchiolitis
Rx
Admit, humidified O2
Supportive care
nebulized epinephrine
antibiotics
pneumonia Support ventilation (nasal
CPAP, ventilator)
2 wheezing
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3 :
2 -5
Amoxycillin
Erythromycin
5 -15
Amoxycillin
Pen V. Erythromycin
2 2
5-7
Admit
S.pneumoniae
& H.influenzae
Pen.
5-7
Admit
Amoxycillin + clavulanic acid
Cefuroxime P.O.
CefprozilP.O.
Cefaclor
P.O.
Mycoplasma
Chlamydiapneumoniae
S.pneumon
Amoxycillin
clavulanic ac
Amoxyci(double dose
Cefuroxime Cefprozil Cefaclor P
Erythromycin
14
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4 : /
/
Admit + Supportive care
< 2 2 -5 5 - 15
PGS Ampicillin I.V.*
+ Aminoglycoside
Cefotaxime
Ceftriaxone
* cloxacillin
S.aureus
Ampicillin I.V.
2-3
Ampicillin
Amoxycillin 7
Ampicillin
+ Aminoglycoside
Cefuroxime I.V.
Cefotaxime I.V.
Amoxycillin +clavulanic acid
S.aureus
Cloxacillin
Penicillin G I
2-3
Pen V Amoxycillin
7
S.pneumon
PGS high do
Cefotax Ceftriax
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5
Rxof first wheezing with respiratory distress in young
children
Nebulized beta2-agonist
10-15
wheeze, resp. distress wheeze
try 2nddose bronchodilator* 10-15
wheeze fast breathing
chest indrawing
Dx-Pneumonia with
wheeze
Rx - oral bronchodilator
+ AB 5
- chestindrawing
admit
fast breathing
chest indrawing
Dx- bronchitis with
wheezing
asthma
Rx- oral bronchodilato
3-5
Dx- Acute bronchiolitis
Rx- Admit, humidified O2
- Supportive care
- nebulized epinephrine
- AB
pneumonia
- First wheezing acute bronchiolitis, ARI with wheeze, first
episode of asthma- AB = antibiotics
* 2nddose bronchodilator nebulized beta2-agonist subcutaneous
beta2-agonist, epinephrin
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6
Rxof recurrent wheezing with respiratory distress in young
children
Nebulized beta2-agonist (1-3 10-15 )
response
wheeze
Rx- Admit
- O2, supportive care
- inhaled short-acting beta2-agonist 1-2 .
- Systemic corticosteroid asthma
- IV aminophylline
- AB pneumonia
Rx- oral bronchodilator
- fast breathing pneumon
AB
- 1-2
- MDI spacer 2 puffs 15 2-3
- Recurrent wheezing acute asthmatic attack post bronchiolitic
wheeze
- oral bronchodilator 1-2
- prophylactic drug
inhaled corticosteroid, cromolyn
