Stridor: Difference between revisions
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== | ==Background== | ||
==Clinical Features== | |||
*Inspiratory stridor | *Inspiratory stridor | ||
**Suggestive of extrathoracic obstruction (Pressure<sub>trach</sub> < Pressure<sub>atm</sub>) | **Suggestive of extrathoracic obstruction (Pressure<sub>trach</sub> < Pressure<sub>atm</sub>) | ||
| Line 13: | Line 11: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Stridor DDx}} | {{Stridor DDx}} | ||
==Evaluation== | |||
===Work-Up=== | |||
*Assess stability of airway | |||
**If unstable, see [[Difficult Airway Algorithm]], see [[Intubation]] and consider surgical intervention/consultation | |||
**If stable consider imaging with video laryngoscope [[GEMC:Airway Procedures]] | |||
***CT of neck can be considered if mass/infection suspected but not dynamic like laryngoscope | |||
==Management== | |||
==Disposition== | |||
==See Also== | ==See Also== | ||
[[Stridor (Peds)]] | *[[Stridor (Peds)]] | ||
==External Links== | |||
==References== | |||
<references/> | |||
[[Category:Critical Care]] | [[Category:Critical Care]] | ||
[[Category:ENT]] | [[Category:ENT]] | ||
Revision as of 10:34, 24 September 2016
Background
Clinical Features
- Inspiratory stridor
- Suggestive of extrathoracic obstruction (Pressuretrach < Pressureatm)
- Croup, metapneumovirus, FB, epiglottitis
- Expiratory stridor vs. wheezing
- Suggestive of intrathoracic obstruction (Pressuretrach < Pressurepleura)
- Asthma, bronchiolitis
Differential Diagnosis
Stridor
Trauma
- Larynx fracture
- Tracheobronchial tear/injury
- Thyroid gland injury/trauma
- Tracheal injury
- Electromagnetic or radiation exposure
- Burns, inhalation injury
Infectious Disorders
- Bacterial tracheitis
- Diphtheria
- Tetanus
- Tracheobronchial tuberculosis
- Poliomyelitis, paralytic, bulbar, or acute
- Fungal laryngitis
Abscesses
- Retropharyngeal abscess
- Epiglottitis, acute
- Peritonsillar abscess
- Laryngotracheobronchitis (croup)
- Retropharyngeal abscess
Neoplastic Disorders
- Neoplasms/tumors
Allergic and Auto-Immune Disorders
- Spasmodic/tracheobronchitis
- Angioedema/Angioneurotic edema
Metabolic, Storage Disorders
- Cerebral Gaucher's of infants (acute)
- Tracheobronchial amyloidosis
Biochemical Disorders
Congenital, Developmental Disorders
- Angioedema/Angioneurotic edema, hereditary
Psychiatric Disorders
- Somatization disorder
Anatomical or Mechanical
- Foreign body aspiration
- Acute gastric acid/aspiration syndrome
- Airway obstruction
- Neck compartment hemorrhage/hematoma
- Paradoxical vocal fold motion [1]
Vegetative, Autonomic, Endocrine Disorders
- Esophageal free reflux/GERD syndrome
- Laryngospasm, acute
- Bilateral vocal cord paralysis
- Hypoparathyroidism
Poisoning
Chronic Pediatric Conditions
- Laryngotracheomalacia[2]
- Subglottic stenosis or prior intubation
- Vascular ring (double aortic arch)
- Vocal cord dysfunction/paroxysmal vocal fold movement
Evaluation
Work-Up
- Assess stability of airway
- If unstable, see Difficult Airway Algorithm, see Intubation and consider surgical intervention/consultation
- If stable consider imaging with video laryngoscope GEMC:Airway Procedures
- CT of neck can be considered if mass/infection suspected but not dynamic like laryngoscope
Management
Disposition
See Also
External Links
References
- ↑ Vocal Cord Dysfunction on Internet Book of Critical Care https://emcrit.org/ibcc/vcd/
- ↑ Ernst A, Feller-Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med 2004