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⚡️Treatment of pertussis is 5 days azithromycin : ▪︎ either 10mg/kg first day then 5mg/kg for 4 days ▪︎ or 5mg/kg for 5 days 🔸️We should give prophylaxis[ azithromycin or Erythromycin ] to mother's and other children in the house

Bronchiolitis Mx

Croup Mx

Pneumonia Mx

👉 “Foreign body aspiration is suggested by sudden onset following a choking episode, with unilateral decreased air entry and poor response to bronchodilators, unlike asthma or infections which are gradual and usually bilateral.”

5. Cause-specific management (VERY IMPORTANT) 🔹 Upper airway infections 📌 Croup • Nebulized adrenaline • Steroids (dexamethasone) • Usually improves ⸻ ⚠️ Epiglottitis • DO NOT examine throat aggressively ❌ • Keep child calm • Urgent controlled intubation in OR ⸻ 🔹 Lower airway obstruction Asthma • Nebulized bronchodilators (salbutamol) • Steroids • Severe → consider ventilation ⸻ 🔹 Foreign body aspiration • If stable → bronchoscopy • If unstable → emergency removal ⸻ 🔴 6. Advanced airway (if failing) Indications: • Decreased consciousness • Severe distress / exhaustion • SpO₂ not improving • Silent chest Steps: • Bag-valve-mask ventilation • Endotracheal intubation ⸻ 🛑 7. Last resort (can’t intubate, can’t ventilate) • Needle cricothyrotomy • Surgical airway (rare in children, but lifesaving)

Airway management in obstruction (Children) 🔴 1. Recognize severity first • Partial obstruction • Stridor, cough, air entry present • Complete obstruction • No air movement, silent chest, cyanosis ⚠️ emergency ⸻ 🅰️ 2. Immediate basic maneuvers (DO FIRST) 🧒 Conscious child • Encourage coughing (if effective) 👶 Infants (<1 year) • 5 back blows + 5 chest thrusts 🧑 Older children • Abdominal thrust (Heimlich maneuver) 👉 Repeat until object expelled or child deteriorates ⸻ 🅱️ 3. Positioning & simple airway opening • Head tilt–chin lift • Jaw thrust (if trauma suspected) • Remove visible foreign body (NO blind sweep ❌) ⸻ 🅾️ 4. Oxygen • Give high-flow O₂ via mask • Monitor SpO₂

1. Immediate assessment (Primary survey – ABCDE) 🅰️ Airway • Is it patent? • Signs of obstruction: • Stridor (→ upper airway) • Drooling (e.g. Epiglottitis ⚠️ emergency) ⸻ 🅱️ Breathing • Respiratory rate (tachypnea is early sign) • Work of breathing: • Nasal flaring • Retractions (intercostal, subcostal) • Grunting • Oxygen saturation (SpO₂) • Chest exam: • Wheeze → lower airway (e.g. Asthma, Bronchiolitis) • Crackles → Pneumonia • Silent chest → severe asthma ⚠️

⚡️In pneumonia steriod is contraindicated while it can be given in bronchiolitis

⚡️In treatment of bacterial pneumonia شوكت نكدر نضيف AB ثاني ؟ ▪︎if my patient is in distress and not become well on one antibiotics (ceftriaxone) we can add vancomycin

⚡️Dose of ceftriaxone ---------------------------------------- ▪︎50mg/kg in pneumonia ▪︎100mg/kg in meningitis

⚡️when you hear rhonchi by stethoscope give nebulizer for patient (with exceptions مو كل مريض يفيدة ) ▪︎rhonchi (wheezing ) = give nebulizer

⚡️we not give the full maintenance dose of fluid in this cases ▪︎chest infection ▪︎CNS infection ▪︎nephrotic syndrome We give 1/2 or 2/3 of the dose only ⚡️ we give twice maintenance in ▪︎ leukemia

⚡️normal saline is used only for rehydration (as shoot)

⚡️بحالات ال S.O.B اذا ال Respiratory rate اعلى من الطبيعي (tachypnic ) نوقف ال feeding ونعلك fluid للطفل لانه ال rapid breathing ممكن يدخلنا ب aspiration pneumonia

⚡️S.O.B + cynosis/apnia + absolute lymphocytosis think about pertussis