NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationMedium
A 3-year-old child presents with a sudden onset of barking cough, inspiratory stridor, and mild respiratory distress. The child has a low-grade fever and appears to be playing comfortably between coughing spells. What is the most likely cause of these symptoms?
- ABacterial epiglottitis.
- BCroup (Laryngotracheobronchitis).
- CAnaphylaxis.
- DForeign body airway obstruction.
Show answer & explanationAnswer & explanation
Correct answer: B. Croup (Laryngotracheobronchitis).
The symptoms of a barking, seal-like cough, inspiratory stridor, low-grade fever, and the child's ability to be comfortable between episodes are classic for croup (laryngotracheobronchitis), which is typically viral.
Why the other options are wrong
- A. Bacterial epiglottitis would present with a high fever, severe drooling, dysphagia, and the child appearing very ill and anxious, often in a tripod position, without a barking cough.
- C. Anaphylaxis would involve a known allergen exposure, widespread hives, angioedema, and potentially severe respiratory distress with wheezing and stridor, but typically not a barking cough or low-grade fever as primary symptoms.
- D. A foreign body airway obstruction would have a sudden onset of choking, gagging, or inability to speak/cough, without a fever or barking cough.
Croup (Laryngotracheobronchitis)
A common pediatric respiratory infection, usually viral, causing inflammation and narrowing of the upper airway, leading to a characteristic barking cough and inspiratory stridor.
- Key signs: 'seal-bark' cough, inspiratory stridor, low-grade fever, hoarseness.
- Symptoms often worsen at night.
- Management includes humidified oxygen, nebulized epinephrine (if severe), and transport.
Memory trick: Barking seal and low fever, that's croup, my little believer!