I-Epiglottitis, iCroup eMandundu, iStridor, kunye ne-Upper Airway Obstruction¶

An acute upper airway obstruction caused by infectious swelling of the throat tissues is one of the fastest-moving emergencies in pediatric and adult medicine. Within minutes to hours, bacterial inflammation of the epiglottis (acute epiglottitis), severe viral swelling below the vocal cords (laryngotracheobronchitis or croup), or a deep bacterial windpipe infection (bacterial tracheitis) can narrow the breathing passage down to a pinhole. Because a child's windpipe is roughly the diameter of their little finger, even 1 millimeter (0.04 inches) of mucosal swelling inside a child's airway reduces the cross-sectional breathing area by more than 60 percent and increases airflow resistance sixteen-fold.

When an inflamed upper airway narrows critically, the patient survives only by sitting upright, leaning forward, and holding their neck in a precise position that keeps a tiny slit of air open. The single greatest danger during prehospital first aid is iatrogenic complete airway closure triggered by well-meaning rescuers who force a panicked child or adult to lie flat on their back, try to look inside their mouth with a spoon or flashlight, or upset a crying child. Knowing how to distinguish the sudden, silent, drooling terror of epiglottitis from the brassy, seal-bark cough of viral croup, why you must keep the patient calm in their chosen tripod posture, and when cool mist or humidified air helps can keep the airway open until an emergency medical team arrives.

Yenza oku ngoku¶

1. Call your local emergency number immediately if anyone has noisy breathing at rest (stridor), drooling with inability to swallow, a muffled "hot potato" voice, tripod posture, or bluish lips. Dial 911 in the United States and Canada, 112 across the European Union, 999 in the United Kingdom, 000 in Australia, or check the directory of amanani kaxakeka. Request an Advanced Life Support (ALS) ambulance and state clearly that you suspect acute upper airway swelling or epiglottitis so paramedics approach quietly without sirens blaring at the door.
2. NEVER force a person with stridor, drooling, or severe throat swelling to lie flat on their back. Let the patient sit completely upright in whatever position feels easiest to breathe, usually leaning forward on their hands with their chin thrust slightly forward (the tripod or sniffing position). For an infant or toddler, let them sit upright held calmly in their parent's lap and arms.
3. NEVER put a tongue depressor, spoon, finger, thermometer, or flashlight inside the mouth to look at the throat. Touching the back of the tongue or forcing the jaw open in suspected epiglottitis triggers an instant vagal laryngospasm or pushes the swollen, cherry-red epiglottis down like a cork into the windpipe, causing immediate and irreversible airway obstruction.
4. Keep a frightened child as calm and quiet as possible in their parent's arms. Crying, screaming, and fighting increase turbulent airflow through the narrowed throat (the Bernoulli effect), which sucks the swollen airway walls inward and worsens hypoxia. Do not separate the child from their caregiver, do not try to pull off their clothes unless necessary, and minimize bright lights or loud noises.
5. Keep the patient strictly NPO (nothing by mouth). Do not offer water, milk, juice, popsicles, honey, or oral fever syrups (such as liquid paracetamol or ibuprofen) to anyone who is drooling, struggling to swallow, or making high-pitched stridor sounds at rest. Attempting to swallow liquid past a swollen epiglottis triggers violent choking and fatal laryngospasm.
6. If the child has a classic "barking seal" cough (viral croup) WITHOUT drooling, sits comfortably, and has mild stridor only when crying, expose them to cool night air or bathroom mist while monitoring closely. Sitting in a cool-mist bathroom or breathing cool outdoor night air for 10 to 15 minutes while comforting the child often shrinks subglottic viral swelling enough to ease mild croup, though any stridor present while the child is calm and resting requires immediate medical evaluation and prescription corticosteroids.

Emergency decision tree for acute stridor and upper airway swelling¶

flowchart TD
    Start["Sudden Noisy Breathing (Stridor), Hoarseness, Barking Cough, or Severe Throat Pain"]
    ChokeCheck{"Did this start INSTANTLY (within seconds)<br/>while eating, playing with small toys, or holding an object in the mouth,<br/>with NO fever or prior illness?"}
    ForeignBody["SUSPECTED FOREIGN-BODY CHOKING / AIRWAY OBSTRUCTION<br/>1. If unable to speak, cough, or breathe: Perform Back Blows & Abdominal Thrusts<br/>   (or Back Blows & Chest Thrusts for infants under 1 year)<br/>2. If coughing forcefully or breathing with stridor: Call EMS immediately;<br/>   do NOT perform blind finger sweeps; keep patient upright"]
    AllergyCheck{"Was the patient exposed to a bee sting, peanut/food allergen,<br/>medication, or has a history of hereditary angioedema,<br/>with swollen lips, tongue, or hives?"}
    Anaphylaxis["ANAPHYLACTIC AIRWAY EDEMA / ANGIOEDEMA<br/>1. Inject Epinephrine Auto-Injector into outer mid-thigh immediately<br/>2. Call EMS (911 / 112 / 999) for urgent transport<br/>3. Keep patient sitting upright if airway/tongue is swollen (unless hypotensive)<br/>4. Give second epinephrine dose at 5 to 15 minutes if no improvement"]
    RedFlagCheck{"Are ANY Epiglottitis or Severe Obstruction Red Flags Present?<br/>- Drooling saliva / unable to swallow own spit<br/>- Sitting upright leaning forward (Tripod / Sniffing posture)<br/>- Muffled 'Hot Potato' voice & absence of barking cough<br/>- High-pitched stridor heard even when resting quietly<br/>- Sternal/rib retractions, lethargy, or bluish/pale skin"}
    EpiglottitisProtocol["CRITICAL UPPER AIRWAY EMERGENCY (EPIGLOTTITIS / SEVERE CROUP / TRACHEITIS)<br/>1. Call EMS (911 / 112 / 999) immediately; request quiet ALS approach<br/>2. Keep patient sitting 100% UPRIGHT (child held in parent's lap)<br/>3. DO NOT look in mouth, DO NOT use tongue blade, DO NOT lay flat<br/>4. Keep strictly NPO (no water, no oral fever medicine)<br/>5. Keep child calm; allow parent to hold blow-by oxygen near face if EMS provides it"]
    MildCroup["LIKELY MILD TO MODERATE VIRAL CROUP (LARYNGOTRACHEOBRONCHITIS)<br/>(Barking seal-like cough, hoarse voice, able to swallow, NO drooling,<br/>NO stridor when resting quietly, alert and drinking fluids)<br/>1. Hold child upright and calm them immediately to stop crying<br/>2. Expose to cool outdoor night air (wrapped warmly) or cool-mist humidifier for 15 min<br/>3. Contact physician or urgent care for single-dose oral Dexamethasone<br/>4. Watch continuously for resting stridor or rib retractions"]

    Start --> ChokeCheck
    ChokeCheck -->|Yes: Sudden Onset, No Fever| ForeignBody
    ChokeCheck -->|No: Preceded by Fever, Cold, or Sore Throat| AllergyCheck
    AllergyCheck -->|Yes: Hives, Lip/Tongue Swelling, Allergen| Anaphylaxis
    AllergyCheck -->|No: Infectious / Inflammatory Pattern| RedFlagCheck
    RedFlagCheck -->|Yes: ANY Red Flag Present| EpiglottitisProtocol
    RedFlagCheck -->|No: Barking Cough Only, Calm at Rest| MildCroup

Comparing life-threatening upper airway emergencies¶

When a child or adult develops noisy breathing (stridor) or throat distress, five major infectious and non-infectious conditions must be differentiated quickly. Unlike wheezing (a musical, whistling sound heard primarily during exhalation from narrowed lower bronchial tubes in asthma), stridor is a harsh, high-pitched, crowing or sawing sound heard primarily during inhalation (or both inhalation and exhalation in severe subglottic narrowing) caused by turbulent airflow through a partially blocked upper throat, voice box (larynx), or windpipe (trachea).

I-Anatomy kunye nefiziksi yokuphazamiseka kwendlela yomoya ephezulu¶

Kutheni ukuvuvukala kwe-1-millimeter kukuphazamiseka kumntu omdala kodwa intlekele emntwaneni¶

Ukuze uqonde ukuba kutheni usana okanye umntwana oselula one-croup okanye i-epiglottitis inokuwohloka ukusuka kwingxolo yokuphefumla ukuya ekubanjweni kokuphefumla ngemizuzu, oogqirha bexesha likaxakeka bafaka isicelo Umthetho wePoiseuille weLaminar kunye ne-Turbulent Fluid Flow:

1. UMthetho wokuNchasa-ukuya-kwiRadiyosi-Mandla weSine (\(R \propto \frac{1}{r^4}\)): Xa ukuhamba komoya kuhamba kakuhle (i-laminar), ukuchasana kwe-airway kuhambelana ngokungafaniyo ne-** amandla esine we-radius ye-airway ** (kwaye xa ukukhala kubangela ukuhamba komoya ophazamisayo, izikali zokumelana ne- ** yesihlanu amandla e-radius **).
2. Abantwana vs. Imilinganiselo yeNdlela yoMoya yaBantu abadala:
3. Isiqhelo indlela yomoya yosana okanye yosana oluncinane kwiringi yecartilage yecricoid inobubanzi obungaphakathi obuyi 4 millimeters kuphela (0.16 intshi) (i-radius ye-2 mm). Ukuba i-croup yentsholongwane ibangela nje ** i-1 millimeter ye-circumferential mucosal swelling ** ngaphakathi kweringi eqinile, i-diameter yangaphakathi yehla ukusuka kwi-4 mm ukuya kwi-2 mm (i-radius ihla ngama-50 ekhulwini ukusuka kwi-2 mm ukuya kwi-1 mm). Ngenxa yokuba i-$ 2 ^ 4 = i-16 $, ukusika i-radius ye-airway kwisiqingatha ** kunciphisa indawo yokuphefumula ngama-75 ekhulwini kwaye kwandisa umsebenzi wokuphefumula nge-1,600 ekhulwini (16-fold) **.
4. Ngokwahlukileyo, isiqhelo uqhoqhoqho lomntu omdala unobubanzi bangaphakathi obumalunga i-20 millimeters (0.79 intshi) (i-radius ye-10 mm). Okufana ngqo 1 millimeter yokudumba okujikelezayo kunciphisa idiameter yabantu abadala ukusuka kwi-20 mm ukuya kwi-18 mm, nto leyo eyandisa ukuxhathisa kwendlela yomoya ngama-50 ekhulwini kuphela (1.5-fold).
5. Kutheni Ukukhala Kwenza Umoya Womoya Uwe (Impembelelo Dynamic Bernoulli): Ebantwaneni, amakhonkco e-cartilage axhasa umgaqo womoya ophezulu kunye ne-larynx athambile kwaye athambile. Xa umntwana owoyikayo ekhala okanye ekhala kwaye ezama ukufunxa umoya ngamandla emqaleni ocuthekileyo, isantya esiphezulu somoya odlula kwiindonga ezidumbileyo sidala uxinzelelo oluluqilima lwevacuum engalunganga ngaphakathi kwilumen yomoya (the Venturi / Bernoulli effect). Olu xinzelelo lubi ngokoqobo lufunxa iindonga ezithambileyo, ezithambileyo zomqala womntwana ngaphakathi ngexesha lokuphefumla, ukuguqula isithintelo esingaphelelanga sibe sisiwohlo esiphantse siphelele. Yiyo loo nto ukugcina umntwana ene-stridor ezolile kwaye ezolile asikokuthuthuzela nje; lungenelelo ngoomatshini olubalulekileyo olusindisa ubomi.

Umahluko we-anatomical phakathi kweSupraglottic kunye nokudumba kweSubglottic¶

• I-Supraglottic Obstruction (Epiglottitis): Yenzeka ngasentla kwimiphimbo kwizihlunu ezikhululekileyo, ezidityanisiweyo. Ngenxa yokuba izicubu ezigqume i-epiglottis kunye ne-aryepiglottic folds zincanyathiselwe ngokukhululekileyo, ulwelo lwebhaktiriya kunye neeseli zegazi ezimhlophe zikhawuleza ibhaluni ye-epiglottis ibe yingqukuva enkulu edumbileyo edada phezu kwe-laryngeal inlet ngexesha lokuphefumlelwa. Ibangela ilizwi elizolileyo, elithambileyo, elisezantsi elikhuthazayo,ilizwi elimfilibayo elithi "itapile eshushu", kunyenokuvuza kuba isigulana asinakuginya kudlule ubunzima obudumbileyo, kodwa **akukho khohlokhohlo **.
• I-Subglottic Obstruction (i-Viral Croup): Yenzeka ngezantsi iintambo zezwi ngaphakathi kwe-cricoid cartilage, ekuphela kwe-cartilage kuyo yonke indlela yomoya yomntu eyenza ikhonkco elipheleleyo, eliqinileyo le-360-degree yesignesha. Ngenxa yokuba i-cricoid ring ayikwazi ukwandisa ngaphandle xa i-lining ihluma, konke ukuvuvukala kunyanzeliswa ** ngaphakathi ** kwi-tube yokuphefumula, ukunweba izintambo zezwi ngaphezulu kwaye kuvelise ukukhwehlela ** okukhulu, ubhedu "olutyhutyhayo" , i- ilizwi elikhwazayo **, kunye ne-*-high-pitched, i-inspiratory enzima (okanye i-biphasic stridor)

Ukuntywila nzulu: I-Epiglottitis ebukhali ebantwaneni nakubantu abadala¶

Ukutshintsha kobuso be-Epiglottitis: Kutheni abantu abadala ngoku besengozini enkulu¶

Phambi kokuqaliswa kwenkqubo yokugonya i-Haemophilus influenzae yohlobo lwe-b (Hib) ye-conjugate* ekupheleni kweminyaka yoo-1980 no-1990, i-acute epiglottitis yayisisifo sabantwana esibetha abantwana abaneminyaka emi-2 ukuya kwe-7 ubudala. Namhlanje, iinyani ezimbini ezibalulekileyo ze-epidemiological kufuneka ziqondwe lusapho ngalunye kunye nomphenduli wokuqala: 1. I-Epiglottitis yabantwana Isaqhubeka: Ihlasela abantwana abangagonyelwanga okanye abangagonyelwanga ngokwaneleyo i-Hib, abantwana abakwimimandla engenalo ugonyo lwe-Hib jikelele, kwanabantwana abagonywe ngokupheleleyo xa bebangelwa zezinye iintsholongwane ezifana ne-Streptococcus pneumoniae, iQela A beta-hemolytic Streptoc, orStacus orStacus ukwenzakala okushushu (ukusela ulwelo olutshisayo okanye ukuphefumla umphunga). 2. I-Supraglottitis yabantu abadala / i-Epiglottitis iyenyuka: Uninzi lwezehlo ze-epiglottitis kumazwe agonyiweyo ngoku zibakhokubantu abadala ababudala buphakathi kwama-20 ukuya kuma-65**. I-epiglottitis yabantu abadala idla ngokungahambi kakuhle ekuqaleni njenge "imeko embi ye-strep throat" ngenxa yokuba umqala omdala ukhangeleka ngokukhohlisayo xa ugqirha ejonga iitoni nge-flashlight (ekubeni i-epiglottis ihleli phantsi, ngaphandle kwembono ngqo).

"IiDs ezine" ze-Acute Epiglottitis¶

Oogqirha bafundisa iklasi Ds ezine ukuqaphela i-epiglottitis ngoko nangoko ngaphandle kokuchukumisa isigulana: 1. Ukuthontsiza (Sialorrhea): Amathe athontsiza ngokuqhubekayo ukusuka esilevini kuba ukuginya kubangela intlungu ebuhlungu yomqala kwaye kusongela ukuminxa indlela yomoya. 2. I-Dysphagia kunye ne-Odynophagia eMandundu: Ukungakwazi ngokupheleleyo ukuginya ulwelo okanye ukutya okuqinileyo. Kubantu abadala, uphawu #1 lwe-epiglottitis lubukhali, iintlungu zomqala ezibuhlungu ("intlungu ezili-10 kwezili-10") ezingekho ngokupheleleyo kumlinganiso womngxuma womlomo okhangeleka njengesiqhelo kunye neetoni. 3. I-Dysphonia ("Hot Potato" Voice): Ilizwi livakala lingqindilili, livalekile, livakala lingekho ngqiqweni, ngokungathi lo mntu uzama ukuthetha ngelixa ebambe igqabi letapile elitshisayo ngasemva emqaleni wakhe. 4. ** Uxinzelelo (I-Inspiratory Stridor kunye ne-Tripod Posture): ** Isigulane sihlala singashukumi, sincike phambili ngezandla ezigxininiswe emadolweni abo (**i-tripod position ), intamo yolulelwe phambili kunye ne-chin iphakanyiswe phezulu ( ukuphunga isikhundla **), ukuphefumla ngokukhawuleza nangokucokisekileyo ukwenzela ukuba ungenzi i-airflow ephazamisayo efunxa i-epittis shuttis.

Inyathelo ngenyathelo lokuqala uncedo lokuqala epiglottitis ekurhaneleka¶

1. Fowunela u-911 / 112 / 999 ngokukhawuleza kwaye ucele i-ALS i-paramedic crew. Tshela umthumeli: *"Ndinomntwana / umntu omdala okrokreleka ukuba yi-epiglottitis evuzayo, ehleli kwindawo emithathu, kwaye kunzima ukuphefumla."
2. Yamkela inkqubo engqongqo ethi "Hands-Off, Calm-Environment":
3. Yenza mnyama izibane ezirhabaxa kwaye ucime umabonakude ongxolayo okanye izilwanyana zasekhaya ezikhonkothayo.
4. Ukuba isigulana ngumntwana, zishiye ezingalweni zomzali wakhe okanye zomnonopheli. Ungaze uzame ukukhupha umntwana okhathazekileyo kude nomama okanye uyise ukuba amvavanye.
5. Vumela isigulane sibambe itawuli okanye ikomityi ngasesilevini ukuze sibambe idrool ukuze singeva ukuba sifuna ukuyiginya.
6. Ungaze ulalise isigulane kwaye ungaze ujonge emlonyeni: Musa ukucela isigulane ukuba "sivule ngokubanzi kwaye sithi ahh." Musa ukukhanya ifowuni phantsi emqaleni wabo.
7. Ukuba isigulana silahlekelwa zingqondo kwaye siyeke ukuphefumla ngokupheleleyo phambi kokuba aboncedo lokuqala bafike:
8. Ukuba umzila womoya uvale ngokupheleleyo kwaye isigulana singaphenduli, sibe ne-cyanotic, kunye ne-apneic, ngononophelo zibeke phantsi ukuze ziqale. CPR (okanye CPR yabantwana).
9. Umgaqo wokuhlangula wokuphefumla ngokugqibeleleyo ekubanjweni kwe-Epiglottitis: Naxa i-epiglottis idumbile ithintela ukuphefumla okuzenzekelayo, ukuphefumla okuqinileyo, okucothayo, okucothayo koxinzelelo olulungileyo (umlomo ukuya emlonyeni okanye i-paramedic's bag-valve-mask) ihlala inyanzela amancinci amancinci, asindisa ubomi ukuphefumla komoya ngelixa i-oksijini yesifuba ifika kwi-lude circucs. ukwenza utyando lomoya olungxamisekileyo.

Ukuntywila nzulu: I-Viral Croup (Laryngotracheobronchitis) kunye ne-Spasmodic Croup¶

Ukuthathela ingqalelo umboniso waphakathi kobusuku weCroup¶

Ngokungafaniyo ne-epiglottitis, i-viral croup ibangela uninzi lweemeko ze-acute stridor kubantwana phakathi kweenyanga ezi-6 kunye ne-3 yeminyaka ubudala. * Kutheni u-Croup ehlasela phakathi kwentsimbi ye-11:00 PM kunye ne-4:00 AM: Umntwana ohambahambayo udla ngokuba nempumlo ethambileyo, ukurhawuzelelwa kancinci, kunye nomkhuhlane ophantsi ngexesha lasemini. Ezinzulwini zobusuku, umntwana uvuka ekhamisa ngesandi esikhulu, esinesinyithi, ** isikhohlela se-seal-bark ** kunye ne-raspy, isandi esikhalayo xa uphefumla (** inspiratory stridor ). I-Croup ifikelela incopho ebusuku kuba i-endogenous cortisol (ihomoni yomzimba yendalo echasene nokudumba) yehla iye kweyona ndawo isezantsi ye-circadian trough phakathi kobusuku kunye ne-4:00 AM, ngelixa ukulala phantsi ebhedini kwandisa igazi le-venous kwi-subglottic lining. **I-Spasmodic Crou Umahluko osondeleleneyo apho umntwana alala esempilweni engenawo nawuphi na umkhuhlane kwaye avuke ngo-2:00 AM enokhohlokhohlo kunye ne-stridor evela kwi-subglottic mucosal edema ngesiquphe.

Ubungqongqo beCroup yoHlelo: ISikhokelo soBungqongqo seWestley Croup sabazali kunye nabaphenduli¶

Ukuqinisekisa ukuba umntwana onokhohlokhohlo olukhohlelayo unokuthuthuzeleka ngomoya opholileyo aze asiwe kwagqirha, okanye afune i-ambulensi ngoko nangoko 911/112/999, kuxhomekekekukuba i-stridor kunye nesifuba sirhoxa xa umntwana ezolile kwaye ephumle:

Safe home and prehospital first aid for Viral Croup¶

1. Pick the child up and hold them upright immediately: Sitting upright reduces blood engorgement in the swollen subglottic mucosa and uses gravity to assist the diaphragm.
2. Soothe and calm the child with quiet reassurance: Sing softly, read a favorite book, or put on a quiet video while holding the child on your lap. Stopping the child from crying immediately converts turbulent airflow back into smooth laminar airflow, often cutting their breathing effort in half within 2 minutes.
3. Apply the Cool Night Air or Cool-Mist Bathroom Protocol (10 to 15 minutes):
4. Option A (Cool Outdoor Night Air or Open Freezer Door): Wrap the child warmly in a blanket and carry them upright onto a porch, by an open window, or in front of an open refrigerator/freezer door to breathe cool, humid night air for 10 to 15 minutes. Cool air causes vasoconstriction of the dilated blood vessels in the subglottic lining, visibly shrinking the swelling and easing the barking cough.
5. Option B (Cool-Mist Humidifier or Bathroom Mist): Run a clean cool-mist humidifier right beside the child, or sit upright with the child in a closed bathroom while running the shower to create a humid mist.
6. CRITICAL BURN WARNING: Never hold a child over a pot of boiling water, a hot stove, or a hot steam vaporizer. Hot steam vaporizers and pots of boiling water cause catastrophic facial and airway scald ukutsha in squirming toddlers, and hot steam can actually increase mucosal blood flow and worsen airway edema.
7. Why every child with croup should be evaluated by a clinician for corticosteroids:
8. Even if cool night air stops a mild croup attack at 2:00 AM, viral subglottic inflammation lasts 3 to 5 days and frequently rebounds the following night.
9. Current international pediatric guidelines (American Academy of Pediatrics, UK NICE, Canadian Paediatric Society, WHO) recommend that all children with croup (even mild croup) receive a single prescribed oral dose of a corticosteroid (typically Dexamethasone) from a physician or urgent care clinic. A single dose of dexamethasone begins shrinking airway swelling within 2 to 4 hours, lasts up to 72 hours, and slashes emergency department return visits and hospitalizations by more than 50 percent.

Six fatal mistakes to avoid in upper airway emergencies¶

1. Mistake 1: Trying to examine the throat with a spoon, finger, or flashlight. Never press down on the tongue or ask a drooling patient with stridor to open wide. In epiglottitis, minimal mechanical stimulation of the pharynx causes complete airway closure and vagal bradycardic arrest.
2. Mistake 2: Giving oral liquids, honey, or fever medicine to a patient with resting stridor or drooling. Giving anything by mouth to a patient with upper airway obstruction risks aspiration, severe coughing spasms, and laryngospasm.
3. Mistake 3: Performing abdominal thrusts (Heimlich maneuver) on a child with infectious croup or epiglottitis. Abdominal thrusts are designed exclusively to expel a solid mechanical foreign body. In epiglottitis or croup, the obstruction is swollen living tissue; abdominal thrusts cannot expel swollen tissue and only panic the child and collapse the airway faster.
4. Mistake 4: Giving over-the-counter cough suppressants, antihistamines, or sedatives. Sedating a child or adult who is working hard to breathe through a narrowed airway removes their conscious respiratory drive and relaxes the pharyngeal muscles holding their throat open, precipitating rapid respiratory arrest. Antihistamines also dry out and thicken airway secretions in viral croup and bacterial tracheitis, causing thick mucus plugs to crust over the narrow windpipe.
5. Mistake 5: Driving a child with severe stridor, drooling, or retractions to the hospital in the back seat of a private car. Always call 911 / 112 / 999 for an ALS ambulance when resting stridor, drooling, or retractions are present.
6. Mistake 6: Confusing upper airway stridor with an asthma attack and forcing an inhaler into a crying toddler's mouth. Asthma causes expiratory wheezing (difficulty pushing air out of the lower lungs), whereas croup and epiglottitis cause inspiratory stridor (difficulty pulling air in past the upper throat). Standard blue salbutamol or albuterol asthma inhalers relax bronchial smooth muscle in the lower lungs; they have zero effect on swollen cartilage lining in the upper throat and can increase heart rate and agitation.

Upper airway emergencies demand calm action and knowing when to keep a patient undisturbed. Consider taking a certified first aid course through your national Red Cross or Red Crescent society, the American Heart Association, or St John Ambulance.

Imibuzo edla ngokubuzwa¶

Imithombo ijongiwe¶

• ** I-American Academy of Pediatrics (AAP, eUnited States) kunye neNkxaso yoBomi obuPhakamileyo baBantwana (PALS / AHA): ** *Ukuqatshelwa kunye noLawulo lwe-Upper Airway Obstruction, i-Viral Croup, i-Epiglottitis, kunye ne-Bacterial Tracheitis *.
• Iziko leSizwe lezeMpilo kunye nokuGqwesa kweNkathalelo (i-NICE, i-United Kingdom) kunye ne-NHS: *Isishwankathelo soLwazi lweKlinikhi: I-Croup, i-Acute Epiglottitis, kunye noVavanyo lwe-Stridor kuBantwana kunye naBantu abadala *.
• ** UMbutho waBantwana baseCanada (i-CPS, eCanada): ** * Ulawulo olukhawulezayo lweCroup kwiSebe leeNgxamiseko kunye nokuSetyenziswa kwe-Prehospital *.
• UMbutho wezeMpilo weHlabathi (i-WHO, iZizwe ngezizwe): Ipokotho yeNcwadi yoKhathalelo lweSibhedlele kuBantwana: iStridor, iCroup, kunye ne-Epiglottitis.
• ISibhedlele saBantwana saseRoyal eMelbourne (RCH, eOstreliya): Izikhokelo zokuSebenza kweKlinikhi: Ukuvalwa ngokukrakra kwendlela yomoya ePhezulu kunye neCroup.

Izikhokelo ezinxulumeneyo¶

• I-CPR yabantwana kunye nosana kunye nokukrwitshwa
• Ukuminxa uncedo lokuqala kubantu abadala kunye nabantwana
• Iimpendulo ze-alergic kunye ne-anaphylaxis yoncedo lokuqala
• Ukuhlaselwa sisifo sombefu kukhathalelo olungxamisekileyo
• CPR yabantu abadala kunye nokuhlangula ukuphefumla
• Amanani kaxakeka kunye nokuthunyelwa kwamanye amazwe