Review + OSA + OHS + Croup

Question 1

How can you treat OSA?

Answer 1

weight reduction, avoidance of alcohol and hypnotic medications

CPAP = TOC

Question 2

What is indicated for OSA patients w/ mild/moderate OSA, unresponsive to CPAP, or not candidates for CPAP, or fail behavioral measures?

Answer 2

Oral appliances (MAD, tongue retaining devices)

Question 3

When are surgical procedures indicated for OSA?

Answer 3

obvious anatomical obstructions, fail or do not tolerate initial therapy w/ CPAP or MAD

always f/u to assess improvement

Question 4

What should you suggest for OHS?

Answer 4

reduce weight, avoid contributors to hypoventilation (alcohol and sedatives)

Question 5

What is your treatment for OHS?

Answer 5

CPAP

Question 6

what should you avoid for OHS?

Answer 6

sedative hypnotics, alcohol, opioids

adjunct therapy = dietary consult, physical activity, oxygen

Question 7

What do all croup patients need?

Answer 7

humidified room + one time PO steroid (dexamethasone)

Question 8

What do you use to treat moderate-severe croup (stridor at rest)?

Answer 8

nebulized racemic epinephrine in addition to supportive care w humidifier and one time steroid (dexamethasone)