Stridor

Introduction

Stridor is an abnormal, high-pitched sound produced by turbulent airflow through a partially obstructed airway.

Stridor is a dangerous finding and may indicate imminent airway obstruction.
It can be inspiratory, expiratory or biphasic.

Clinical presentation of stridor

1. Hypoxia
2. Respiratory distress
3. Altered mental status
4. Inability to speak
5. Inability to swallow

Differential diagnoses

1. Infectious causes
   • Croup, epiglottitis, peri-tonsillar abcess, retropharyngeal abcess
2. Non- infectious causes
   • Foreign body obstruction, burns, trauma, malignancy, laryngotracheomalacia, stenosis, anaphylaxis

Investigations

• Blood gases analysis,
• Lateral neck X ray (for foreign body, masses or soft tissue swelling),
• CXR (foreign body, evidence of aspiration),
• CT- scan,
• Blood Sugar,
• Lactate,
• Electrolyte analysis and/or
• Serum creatinine and urea

Treatment for stridor

Non Pharmacological Treatment

1. Keep the patient calm by allowing the patient to assume their most comfortable position.
2. Give oxygen if there are signs of increased work of breathing.

Pharmacological treatment

A: Adrenaline (nebulization) 0.5mls/kg

And

A: prednisolone (PO) 1-2mg/kg stat

Or

D: dexamethasone (PO) 0.6mg/kg stat

Note

Administer IV fluids (if signs of shock)

Referral:

All patients with stridor whom the cause has not yet been established must be referred to higher health facilities.