CAUSES of Stridor
| History | Examination | Age | Frequency | Tests | Management | |
| Croup | Associated URTIBarking cough | +/ fever, not toxichigh pitched stridor | 6 m6y mean 18m | Common | Nil | Supportive SteroidsAdrenaline |
| Epiglottitis | Sudden onsetRapid progressionNo preceding coughURTI 2550% | Sitting upToxic, pale, droolingLow pitched stridor | 90% 2yr | Rare in immunised children | XrayBlood culture | AntibioticsSupportive |
| Foreign body | Possible choking episodeFood 70%Prolonged course possible30% deaths due to balloons | Wheeze (80%), decreased AE (50%) cough (40%) stridor (10%) resp distress (20%) fever (15%) pneumonia (15%) | 70% < 3yrs1/3 deaths > 3yrs | Potentially common | Xray – 75% sensitive, 45% specific, not sufficient to accurately exclude FB | Bronchoscopy and removal |
| Bacterialtracheitis | URTI for a few days High feverNeck painCough (often dry) | Unwell lookingOften prefer to lie flat | 15 years of age | Uncommon | Xray may show scalloped appearance of internal trachea | Antistaphylococcal coverCeftriaxone 50mg/kg IVCefotaxime 50mg/kg IVTazocin 5075mg/kg IV |
| Retropharyngeal abscess | FeverNeck painSore throatDysphagia | DroolingHyperextension of neck, torticollis | Usually < 6 years oldmedian 3 years | Uncommon | XrayCT | AntibioticsAirway management+/ surgical management |
| Trauma | Mechanical blow to neckChemical or thermal ingestions/inhalations | Bruising, lacerations to ant neck, burnsDysphagia and drooling | Rare | XrayBronchoscopy | SupportiveSurgical | |
| Congenitale.g. tracheomalacia subglottic stenosis, vascular anomaly | Long term stridorPrematurity | Low grade stridor – may be exacerbated by URTI | < 6 months | Uncommon | Initial management as per croup Specialist referral |