Respiratory Problem in Children

• "Cold"


  Upper respiratory infection or rhinitis

  
• Nasopharyngitis


  Swelling of the nasal passages and the back of the throat

  
• Symptoms of viral nasopharyngitis appear within 1 – 3 days of getting infected and last 1 week to 10 days or longer
• Group at risk


  • Babies and children have higher risk for colds
  • School children are especially at risk due to easy spread of the virus
  • Being in close contact with someone infected
  • Any group situation where one or more people have colds: office, gym, sports events, party, crowded places
  • People with weakened immune system
• Diagnosing Viral Nasopharyngitis


  1. Doctor will ask questions about the symptoms

  2. Physical examination (nose, throat, and ears)

  3. Swab test

  4. Swollen lymph node

  5. Recurrence of nasopharyngitis –referral to ENT specialist
• Over-the-counter medications


  • Zinc supplements
  • Cough suppressants (Robitussin, Zicam, Delsym or Codeine)
  • Nasal spray (fluticasone propionate - Flonase)
  • Antiviral for influenza
  • Vapor rub (Vicks VapoRub)
  • Saline nasal spray
  • Decongestants (pseudoephedrine - Sudafed)
  • Lozenges
  • NSAIDS (aspirin, ibuprofen - Advil, Motrin)
  • Mucus thinners (guaifenesin - Mucinex)
• Alternative Treatment


  • Use a humidifier or vaporizer
  • Breathe in steam from hot water or a shower, to help relieve congestion
  • Eat chicken soup
  • Dissolve ½ teaspoon of salt in warm water and gargle it
  • Add honey to warm water to help soothe a sore throat (don't give honey to children under 1 year old)
  • Don't smoke or avoid secondhand smoke
• Tonsillitis


  An inflammation of the tonsils, which are two oval-shaped pads of tissue at the back of the throat — one tonsil on each side
• Tonsils


  • The first line of defense of the immune system against bacteria and viruses
  • This function makes the tonsils particularly vulnerable to infection and inflammation
  • The function of the tonsil's immune system declines after puberty — accounts for the rare cases of tonsillitis in adults
• Risk factors for Tonsillitis


  • Young age - tonsillitis most often affects children
  • Frequent exposure to germs - school-age children are in close contact with their peers and frequently exposed to viruses or bacteria that can cause tonsillitis
  • Tonsillitis caused by bacteria is most common in ages 5 to 15
• Call the doctor if child is experiencing a sore throat with fever, a sore throat that doesn't go away within 24 to 48 hours, painful or difficult swallowing, extreme weakness, fatigue or fussiness
• Get immediate care if the child has difficulty breathing, extreme difficult swallowing, or excessive drooling
• Epistaxis


  Nosebleeds, which can occur easily because of the location of the nose and the close-to-the-surface location of blood vessels in the lining of the nose

  
• How to stop a nosebleed?

  1. Relax

  2. Sit upright and lean body and head slightly forward

  3. Do NOT lay flat or put the head between legs

  4. Breathe through the mouth

  5. Use a tissue or damp washcloth to catch the blood

  6. Use thumb and index finger to pinch together the soft part of the nose

  7. Pinch the soft part of the nose against the hard bony ridge that forms the bridge of the nose

  8. Keep pinching the nose continuously for at least 5 minutes (timed by clock) before checking if the bleeding has stopped

  9. Apply an ice pack to the bridge of the nose

  10. Spray an over-the-counter decongestant spray into the bleeding side of the nose and apply pressure to the nose

  11. After the bleeding stops, DO NOT bend over, strain and/or lift anything heavy, DO NOT blow or rub the nose for several days
• When to go to the emergency room: Bleeding won't stop after more than 15 to 20 minutes of applying direct pressure
• How to stop a nosebleed

  1. Keep pinching the nose continuously for at least 5 minutes

  2. If it is still bleeds, continue squeezing the nose for another 10 minutes

  3. Apply an ice pack to the bridge of the nose
• How to stop a nosebleed

  1. Spray an over-the-counter decongestant spray into the bleeding side of the nose

  2. Apply pressure to the nose
• WARNING: Topical decongestant sprays should not be used over a long period of time as it can increase the chance of a nosebleed
• After the bleeding stops, DO NOT bend over, strain and/or lift anything heavy. DO NOT blow or rub the nose for several days
• When to go to the emergency room

  1. Bleeding won't stop after more than 15 to 20 minutes of applying direct pressure on the nose

  2. The bleeding is rapid, or the blood loss is large (more than a cup)

  3. Having difficulty of breathing

  4. Have vomited due to large amount of blood swallowed

  5. If nosebleed is caused by a blow in the head or serious injury
• Sinusitis


  An inflammation or swelling of the tissue lining the sinuses
• Causes of Sinusitis


  • The common cold
  • Allergic rhinitis - swelling of the lining of the nose caused by allergens
  • Nasal polyps - small growths in the lining of the nose
  • A deviated septum, which is a shift in the nasal cavity

  
• Causes of Sinusitis for children

  • Allergies
  • Illnesses from other kids at daycare or school
  • Pacifiers
  • Bottle drinking while lying on the back
  • Smoke in the environment
• Acute sinusitis


  Usually starts with cold-like symptoms such as a runny, stuffy nose and facial pain. It may start suddenly and last 2-4 weeks
• Subacute sinusitus


  Usually lasts 4 to 12 weeks
• Chronic sinusitus


  Symptoms last 12 weeks or longer
• Recurrent sinusitis


  Happens several times a year
• Symptoms of Acute Sinusitis

  • Facial pain or pressure
  • "Stuffed-up" nose
  • Runny nose
  • Loss of smell
  • Cough or congestion
  • Thick green, or yellow nasal discharge

  
• Chronic Sinusitis Symptoms


  • A feeling of congestion or fullness in the face
  • A nasal obstruction or nasal blockage
  • Pus in the nasal cavity
  • Fever
  • Runny nose or discolored postnasal drainage
  • Headaches, bad breath, and tooth pain and fatigue

  
• Treatment for Sinusitis


  • Decongestant
  • Saline nasal wash
  • Antibiotics – 10 to 14 days
  • Steroids
  • Warm, moist air
  • Steam inhalation
  • Vaporizer
• Laryngitis


  An inflammation of the voice box (larynx) from overuse, irritation or infection
• Larynx


  The voice box, containing the vocal cords which are 2 folds of mucous membrane covering muscle and cartilage
• Causes of Acute Laryngitis

  • Viral infections similar to those that cause a cold
  • Vocal strain, caused by yelling or overusing your voice
  • Bacterial infections, although these are less common
• Causes of Chronic Laryngitis

  • Inhaled irritants, such as chemical fumes, allergens or smoke
  • Acid reflux, also called gastroesophageal reflux disease (GERD)
  • Chronic sinusitis
  • Excessive alcohol use
  • Habitual overuse of your voice (singers or cheerleaders)
  • Smoking
• Less common causes of Chronic Laryngitis

  • Bacterial infections
  • Fungal infections
  • Infections with certain parasites
• Causes of Chronic Hoarseness

  • Cancer
  • Vocal cord paralysis – may result from nerve injury due to surgery
  • Injury to the chest or neck
  • Bowing of the vocal cords
  • Nerve disorders and other health conditions
• Risk factors for Laryngitis

  • Having a respiratory infection (cold, bronchitis or sinusitis)
  • Exposure to irritating substances (smoking, excessive drinking of alcohol, stomach acid, inhalation of chemicals)
  • Overusing of voice (too much speaking, too loud speaking, shouting or singing)
• Symptoms of Laryngitis


  • Hoarseness
  • Weak voice
  • Loss of voice
  • Tickling sensation and rawness in your throat
  • Sore throat
  • Dry throat
  • Dry cough
• Seek immediate medical attention if child has symptoms that may indicate croup or epiglottitis
• Croup


  A viral condition that causes swelling around the vocal cords