Sinusitis: Symptoms, Acute & Chronic Management

Sinusitis

• Inflammation of the sinuses can be caused by an allergic reaction.
• Symptoms include Nasal congestion, Thick green or yellow mucus, Pain/pressure around face, Decreased sense of smell, Coughing (especially at night), and Fatigue.

Acute Sinusitis Management

• Moist air reduces sinus congestion and alleviates discomfort.
• Saline helps clear mucus and debris, facilitates sinus drainage, and reduces irritation in the nasal passages.
• Decongestants can help relieve nasal congestion by reducing swelling in the nasal passages and improving sinus drainage, but should only be used for short periods.
• Antihistamines are useful if the sinusitis is allergy-related, but generally not recommended for viral sinusitis.
• Antibiotics are only necessary for bacterial sinusitis, typically if symptoms are severe, persist beyond 10 days, or worsen after initial improvement.

Chronic Sinusitis Management/Caldwell-Luc procedure

• Positioning the patient on their side post-surgery can help facilitate drainage and reduce pressure on the surgical site, minimizing discomfort and promoting healing.
• Maintaining a patent airway after surgery is crucial to ensure that the patient can breathe freely, monitoring for swelling or drainage in the upper airways.
• Cool mist or humidified air can help relieve dryness in the nasal and throat areas, moisturizing the mucous membranes.
• Applying an ice compress over the nose or face constricts blood vessels, which helps minimize swelling and pain.
• Good oral hygiene is essential after the Caldwell-Luc procedure.
• Hydration is essential post-surgery to help thin mucus and promote drainage from the sinuses.
• A CSF leak can occur if the surgery accidentally punctures the floor of the sinus cavity, requires prompt medical attention.
• A persistent or high fever could be a sign of infection and should be investigated.
• Pain is typically managed with analgesics to improve patient comfort and Adequate pain control also helps reduce patient anxiety recovery.
• Vision disturbances, promptly evaluate double vision, or eye pain.

CROUP

• Croup is a respiratory infection that affects young children
• Characterized by swelling of upper airway (larynx, trachea, bronchi)
• Symptoms include Narrowed airway and DOB, accompanied by distinctive "barking" cough and stridor (high pitched sound during inhalation)

Types Of Croup

• Infectious Croup, caused by Parainfluenza virus & Measles
• Spasmodic croup, caused by laryngeal spasm
• Symptom Severity: Severity can be mild, severe, or moderate.
• Recovery: Less severe cases are often self-limiting and quicker to recover from.
• 2 types of pneumonia, Bacteria (green/orange secretion) & Viral (white secretion).

Infectious Croup

• Cause: Viral infection
• Onset: Gradual, following cold symptoms
• Fever: Common due to viral infection
• Symptoms: Barking cough, stridor, hoarseness, fever, runny nose
• Duration: Several days (3-7 days)
• Treatment: Steroids, nebulized epinephrine, supportive care
• Recurrence: Less common

Spasmotic Croup

• Cause: Airway spasms, allergies, or irritants
• Onset: Sudden, often at night
• Fever: Rare or absent
• Symptoms: Barking cough, stridor, hoarseness, no fever
• Duration: Quick resolution (a few hours)
• Treatment: Humidified air, steroids, epinephrine (if severe)
• Recurrence: May recur in episodes, often triggered by specific factors

Management - Sweat

• Steroids are used to reduce inflammation in the upper airways
• Caution: Prolonged use of steroids may increase the risk of infection but short term use is generally safe.
• Warm steam inhalation is used to humidify the air, which helps to moisten the airways and reduce the irritation that worsens symptoms of croup.
• Epinephrine is a bronchodilator that relaxes the muscles around the airways to reduce airway narrowing and improve airflow.
• Antibiotics are generally not effective for viral croup, as it is caused by viruses
• Cold air (especially during dawn or snow) can have a therapeutic effect on the airways as the cold, dry air can help to reduce swelling

Management - Procedure Rationale

• Frequent swallowing may indicate blood draining from the surgical site.
• Increased anxiety or agitation (due to discomfort or choking).
• Throat clearing may indicate the presence of blood in the throat.
• Early regognition of shock symptoms can lead to medical intervention in case of blood loss.
• Hypo with tachy

Diet (Cool Liquids, Non-Irritating)

• Helps soothe the throat, reduce swelling, and prevent irritation during recovery.

Bronchial Asthma

• Inflammation of the mucosal lining of the bronchial tree and constriction of the bronchial smooth muscles

Extrinsic Risk Factors

• Allergens
• Molds
• Feathers/furs
• Pollens
• Fumes and Smoke
• Dustmite-most common

Intrinsic Risk Factors

• Stress
• Anxiety
• Genetic
• Asthma

Signs and Symptoms

• Wheezing (a high-pitched whistling sound when exhaling)
• Shortness of breath
• Chest tightness or pain
• Frequent coughing, especially at night or early in the morning
• Increased mucus production in the airways

Intervention and Medication Rationale

• Avoid Triggers, prevents asthma exacerbations by reducing exposure to allergens/irritants that cause airway inflammation.
• Semi-Fowler's Position, Eases breathing by improving lung expansion and reducing diaphragm pressure, aiding airflow.
• Frequent Rest & Fluid Intake, Reduces fatigue and thins mucus, making it easier to clear airways and preventing worsening symptoms.
• Humidification/Oxygen Therapy Soothes irritated airways and helps with mucus clearance, while oxygen therapy supports proper oxygenation.
• Bronchodilators (Ttheophylline), Relaxes airway smooth muscles, reducing and improving airflow.
• Corticosteroids (Prednisone) Reduces inflammation in the airways, helping exacberations and improving overall control.
• Antihistamines (Diphenhydramine) . Reduces allergic responses and airway inflammation caused by histamine release, particularly in allergic asthma(e.g.,
• Mucolytics & Expectorants, helps to clear and mucus from the,improving airflow and reducing obstruction

Notes

• Hyperinflation in lungs is seen as sign of air trapping
• A reduced PEF can indicate bronchoconstriction

COPD

Bronchitis

Smoking
Lower respiratory airway
Inflammation
Blue bloater

Emphysema

Alveolar walls
Over expansion, stretching
Pink puffer

Differentials

• COPD is a lung disease that causes difficulties due to damage to the lungs
• It is characterized by making it harder to breathe.
• COPD involves two main conditions

Chronic Bronchitis

• Causes inflammation narrowing of the tubes (airways) w
• Excessive mucus production.

Emphysema

• Damages the sacs to exchange of oxygen and carbon dioxide.
• Together, these conditions impair airflow
• Limit oxygen which lead to significant distress

Symptoms of COPD

• Develop slowing with common symptoms of cough
• Shortness of breath (especially during activities)
• Wheezing
• Mucus
• Frequent respiratory infections
• Cyanosis.
• COPD symptoms tend to worsen.

Main Risk factors

• Smoking is the factor of COPD
• Exposure exposure
• Exposure to air pollution.
• disorder (Alpha-1 COPD.
• Age increases, childhood can cause to damage to the COPD

What's The Fact!?!?:

• Chronic bronchitis causes and side.
• causes the term
• Emphysema drive, meaning