NREMT Paramedic Cognitive ExamAirway, Respiration & VentilationEasy
A 3-year-old child presents with a sudden onset of inspiratory stridor, mild respiratory distress, and a 'barking' cough. The child has no fever and appears generally well otherwise. What is the MOST likely cause of these symptoms?
- AForeign body aspiration.
- BAnaphylactic reaction.
- CViral laryngotracheobronchitis (croup).
- DBacterial epiglottitis.
Show answer & explanationAnswer & explanation
Correct answer: C. Viral laryngotracheobronchitis (croup).
The classic triad of symptoms for croup (laryngotracheobronchitis) is a 'barking' cough, inspiratory stridor, and hoarseness, often without significant fever. This viral infection typically affects children aged 6 months to 3 years and is characterized by subglottic swelling.
Why the other options are wrong
- A. Foreign body aspiration would typically have a sudden onset of choking, coughing, or respiratory distress, but a 'barking' cough is less typical.
- B. Anaphylaxis would involve systemic symptoms like urticaria, angioedema, and hypotension, not just respiratory symptoms with a barking cough.
- D. Bacterial epiglottitis would present with high fever, drooling, and dysphagia, not a barking cough.
Croup (Laryngotracheobronchitis)
Croup is a common viral infection of the upper airway, primarily affecting young children, characterized by inflammation and swelling of the larynx, trachea, and bronchi. Key symptoms include a distinctive 'barking' cough, inspiratory stridor, and hoarseness.
- Caused by viral infection (e.g., parainfluenza virus).
- Affects children 6 months to 3 years most commonly.
- Symptoms: barking cough, inspiratory stridor, hoarseness, low-grade fever or afebrile.
- Management: humidified oxygen, nebulized racemic epinephrine, corticosteroids.
Memory trick: Barking, stridor, no fever? Croup's the clear receiver.