NREMT Paramedic Cognitive ExamAirway, Respiration & VentilationEasy
A 4-year-old child presents with a sudden onset of a 'barking' cough, stridor, and mild respiratory distress. The child is afebrile and has no history of recent illness. Auscultation reveals clear lung sounds bilaterally. The most likely cause of these signs and symptoms is:
- AForeign body aspiration
- BEpiglottitis
- CCroup (Laryngotracheobronchitis)
- DBacterial tracheitis
Show answer & explanationAnswer & explanation
Correct answer: C. Croup (Laryngotracheobronchitis)
The classic presentation of a 'barking' or 'seal-like' cough, stridor, and mild respiratory distress in an afebrile child, often without a significant prodromal illness, is highly suggestive of Croup (Laryngotracheobronchitis), which is typically viral in origin.
Why the other options are wrong
- A. Foreign body aspiration would likely have a sudden onset of choking, coughing, or gagging, and stridor might be present but the 'barking' cough is less characteristic without a viral prodrome.
- B. Epiglottitis typically presents with high fever, dysphagia, drooling, and a muffled voice, often without a cough.
- D. Bacterial tracheitis is less common and usually presents with high fever, severe respiratory distress, and a toxic appearance.
Croup (Laryngotracheobronchitis)
Croup is a common viral infection of the upper airway, primarily affecting children, characterized by swelling around the larynx, trachea, and bronchi, leading to a distinctive 'barking' cough, stridor, and hoarseness.
- Caused primarily by parainfluenza virus.
- Symptoms are often worse at night.
- Management includes humidified oxygen, nebulized epinephrine, and corticosteroids.
Memory trick: Kids' Croupy Coughs Are Obstructive