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Old 10-30-2011
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Kids Best initial therapy for barking cough in a child

A 2-year-old boy is brought to the emergency department with a barky cough for 1 day. He has had congestion and rhinorrhea for the 2 days prior to this. On physical examination, he has a temperature of 38.8C and his respiratory rate is 28. He has suprasternal retractions and stridor at rest. Which is the best initial therapy?

(A) albuterol via nebulizer
(B) racemic epinephrine via nebulizer
(C) steroids via nebulizer
(D) antibiotics via nebulizer
(E) endotracheal intubation
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Old 10-30-2011
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(C) steroids via nebulizer???
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the answer is B
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B is the answer.....
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Default yes and yes the answer is B

and here's why:

Croup (acute laryngotracheobronchitis) is the most common cause of acute stridor in children. It is more common during late fall and winter. There is typically an upper respiratory infection (URI) before stridor develops. Many children will have a barky cough and mild respiratory distress. Most episodes of croups will be self-limited but some require therapy. The acute treatment relies on inhaled racemic epinephrine to reduce airway edema and stridor. Therapy with dexamethasone following racemic epinephrine is indicated to prevent recurrence of stridor.
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oopss just missed it with steroids.....thought an anti inflammatory would do....ok now i understood...
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why is D not right? It looks to relieve the symptoms more quicker.
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Quote:
Originally Posted by demnchun View Post
why is D not right? It looks to relieve the symptoms more quicker.
D u mean antibiotics?

in croup the thing to remember is that the airway is compromised and to relief this patient of suffocation complication, we need to immediately administer epinephrine via inhaler to ease the swelling and release the airway.
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