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Children’s Health Matters with Dr. Kyon Hood: Pneumonia and Croup – Spotsylvania Reg Medical Center

October 18, 2019

(gentle music) – Pneumonia, again another
lower respiratory illness, can be caused by different things, including viruses or bacteria. So it can present similar to
asthma or to bronchiolitis, but in some cases it
can present differently if it’s a bacterial pneumonia. You can often have,
like I said before, cough, difficulty breathing, but with pneumonia it’s not
uncommon to have chest pain, and you can also have
high fevers as well. This is often diagnosed
by getting an x-ray, which we routinely do
in the emergency room. And there’s different
presentations on x-ray. If it’s a viral pneumonia, you’ll see inflammation kind of throughout the lungs diffusely. And if it’s a bacterial
pneumonia, usually you’ll see one
area of consolidation or inflammation in one area
of the lung. And in those cases, you
clearly need antibiotics. If it’s a viral pneumonia,
it’s simply supportive care, which may need to be oxygen or
just simply cough medicines. If you are the correct age,
you know, hydration and then cool
mist humidifier at night just to help keep the
airway moist so that it doesn’t aggravate
and make the cough worse. With regard to croup, this is different than the
other respiratory illnesses in that it’s actually an
illness of the upper airway. Instead of affecting the
lower and smaller airways, it affects the upper airway
and it causes the same thing. It’s again caused by a virus, usually it’s the
para-influenza virus, but the RSV virus can
actually cause croup as well. And it causes an inflammation
of the upper airway. It causes, again, a narrowing. The difference, instead of wheezing, it presents with strider, which is basically a loud,
turbulent noise when you’re breathing in
like this. (labored breathing) So when you see your child
doing that, it can be extremely
alarming and very scary. So if they’re doing that
at rest, even when they’re not upset
and crying, that’s another time when
you might want to consider getting to the emergency room
immediately, or even calling 911, as they may need emergency
respiratory treatments. The standard treatment,
respiratory wise, is a nebulizer, similar
to albuterol, but it’s racemic epinephrine. That again kind of opens
up the airway a little bit. And once again, your
child would need steroids if they presented in this manner. Rarely do we do x-rays. If they don’t respond, we
sometimes order an x-ray, to check the airway with the soft tissue neck x-ray. You can actually see
narrowing of the upper airway that looks like almost
like a steeple. We actually call it
a steeple sign. And that’s a pathognomonic
presentation on an x-ray. And sometimes if kids don’t respond and we have to admit them, you know, we’ll order that x-ray. In addition to supportive care, sometimes children need
repeated treatments and have to be admitted. The best thing to do
at home for this, if they present with just
a barky cough or if they start to present
with a little bit of strider, then you can take them outside if it’s a cool, damp night, give them some supportive care
that way. Or if you’re not able
to take them outside, you can turn on the shower and steam up the bathroom. Just any humidified air
can sometimes help it. But in the more severe cases, where they’re really having
severe strider and difficulty breathing, they really need to be seen by a physician immediately,
and, most likely, by an emergency room physician, as this typically happens
in the middle of the night. (gentle music)

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