Stridor - Diagnosis and Management
 • Acute Rx: IV ...
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Stridor - Diagnosis and Management

 • Acute Rx: IV access, racemic epinephrine neb x1 STAT if concern for supraglottic source, 10 mg dexamethasone IV x1 STAT, 100% O2 by non-rebreather; consider IM/IV epinephrine and benadryl if allergy suspected; consider Heliox

    o If unstable → Call RICU & trauma surgery for possible surgical airway

    o If stable → Call ENT for airway evaluation

 • Epinephrine dosing If allergic reaction suspected: 0.3mg IM (1:1,000 solution) or 0.1mg IV (1:10,000 solution)

 • Hx: timing/evolution, inspiratory/expiratory/biphasic, inciting events, prior episodes, evidence of infection, allergy, hx EtOH/tobacco (cancer risks), hx of known cancer of head and neck, radiation

 • DDx (in adults): iatrogenic/post-intubation (laryngeal/vocal cord edema/praxis of the recurrent laryngeal nerve from ET tube); infectious (epiglottitis, laryngitis, laryngotracheitis [croup], bacterial tracheitis, Ludwig’s angina); allergic; tumor/mass of larynx or trachea; neurological (vocal cord spasm or immobility); foreign body/trauma

 • Imaging: If stable consider CT scan with contrast of head/neck/chest to localize source



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