Stridor: Difference between revisions
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{{Adult top}} [[stridor (peds)]].'' | |||
==Background== | ==Background== | ||
*Stridor refers to harsh upper airway sounds | *Stridor refers to harsh upper airway sounds, classically inspiratory | ||
==Clinical Features== | ==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>) | ||
** | **[[Aspirated foreign body|foreign body]], [[epiglottitis]] | ||
*Expiratory stridor vs. wheezing | *Expiratory stridor vs. [[wheezing]] | ||
**Suggestive of intrathoracic obstruction (Pressure<sub>trach</sub> < Pressure<sub>pleura</sub>) | **Suggestive of intrathoracic obstruction (Pressure<sub>trach</sub> < Pressure<sub>pleura</sub>) | ||
**Asthma | **[[Asthma]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
*Assess | *Assess airway | ||
**If unstable, see [[Difficult Airway Algorithm]], | **If unstable, see [[Difficult Airway Algorithm]], [[Intubation]] and consider surgical intervention/consultation | ||
**If stable consider imaging with video laryngoscope [[GEMC:Airway Procedures]] | **If stable, consider imaging or direct visualization of larynx with fiberoptic scope or video laryngoscope [[GEMC:Airway Procedures]] | ||
*CT of neck if mass/infection suspected | |||
==Management== | ==Management== | ||
* | *Treat underlying cause | ||
==Disposition== | ==Disposition== | ||
*Based on underlying cause | |||
==See Also== | ==See Also== | ||
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==External Links== | ==External Links== | ||
==References== | ==References== | ||
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[[Category:Critical Care]] | [[Category:Critical Care]] | ||
[[Category:ENT]] | [[Category:ENT]] | ||
[[Category:Symptoms]] | |||
Latest revision as of 16:48, 1 July 2020
This page is for adult patients. For pediatric patients, see: stridor (peds).
Background
- Stridor refers to harsh upper airway sounds, classically inspiratory
Clinical Features
- Inspiratory stridor
- Suggestive of extrathoracic obstruction (Pressuretrach < Pressureatm)
- foreign body, epiglottitis
- Expiratory stridor vs. wheezing
- Suggestive of intrathoracic obstruction (Pressuretrach < Pressurepleura)
- Asthma
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
- Assess airway
- If unstable, see Difficult Airway Algorithm, Intubation and consider surgical intervention/consultation
- If stable, consider imaging or direct visualization of larynx with fiberoptic scope or video laryngoscope GEMC:Airway Procedures
- CT of neck if mass/infection suspected
Management
- Treat underlying cause
Disposition
- Based on underlying cause
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