Laryngotracheomalacia
Accounts for 60%
Usually exacerbated by viral URI
Dx w/ flexible fiberoptic laryngoscopy
Vocal cord paralysis
Stridor associated w/ feeding problems, hoarse voice, weak and/or changing cry
May have cyanosis or apnea if bilateral (less common)
Subglottic stenosis
Congenital vs 2/2 prolonged intubation in premies
Airway hemangioma
Usually regresses by age 5
Associated w/ skin hemangiomas in beard distribution
Vascular ring/sling
Accounts for 60%
Usually exacerbated by viral URI
Dx w/ flexible fiberoptic laryngoscopy
Stridor associated w/ feeding problems, hoarse voice, weak and/or changing cry
May have cyanosis or apnea if bilateral (less common)
Congenital vs 2/2 prolonged intubation in premies
Usually regresses by age 5
Associated w/ skin hemangiomas in beard distribution<unk> 
viral laryngotracheobronchitis
6 mo- 3 yr, peaks at 2 yrs
Most severe on 3rd-4th day of illness
Steeple sign not reliable- diagnose clinically
Epiglottitis
H flu type B
Have higher suspicion in unvaccinated children
Rapid onset sore throat, fever, drooling
Difficult airway- call anesthesia/ ENT early
Bacterial tracheitis
Rare but causes life-threatening obstruction
Sx of<unk>  + toxic-appearing = bacterial tracheitis
Foreign body (sudden onset)
Marked variation in quality or pattern of stridor
Retropharyngeal abscess
Fever, neck pain, dysphagia, muffled voice, drooling, neck stiffness/torticollis/extension
viral laryngotracheobronchitis
6 mo- 3 yr, peaks at 2 yrs
Most severe on 3rd-4th day of illness
Steeple sign not reliable- diagnose clinically
H flu type B
Have higher suspicion in unvaccinated children
Rapid onset sore throat, fever, drooling
Difficult airway- call anesthesia/ ENT early
Have higher suspicion in unvaccinated children
Rare but causes life-threatening obstruction
Sx of<unk>  + toxic-appearing = bacterial tracheitis
Marked variation in quality or pattern of stridor
Fever, neck pain, dysphagia, muffled voice, drooling, neck stiffness/torticollis/extension
Airway obstruction
Anaphylaxis
Angioedema
Aspirated foreign body
Asthma exacerbation
Anaphylaxis
Angioedema
Aspirated foreign body
Asthma exacerbation
Structural
Bronchopulmonary dysplasia
Choanal atresia
Neoplasm
Subglottic stenosis
Tracheoesophageal fistula
Tracheomalacia
Spontaneous pneumothorax
Bronchopulmonary dysplasia
Choanal atresia
Neoplasm
Subglottic stenosis
Tracheoesophageal fistula
Tracheomalacia
Spontaneous pneumothorax
Infectious
Bacterial tracheitis
Bronchiolitis (peds), URI<unk> 
Epiglottitis
Pertussis
Pneumonia
Cystic fibrosis exacerbation
Bacterial tracheitis
Bronchiolitis (peds), URI<unk> 
Epiglottitis
Pertussis
Pneumonia
Cystic fibrosis exacerbation
Trauma
Rib fractures
Flail chest
Traumatic pneumothorax
Pulmonary contusion
Rib fractures
Flail chest
Traumatic pneumothorax
Pulmonary contusion
Other
Inhalation exposure
Meconium aspiration syndrome
Pulmonary edema
Pulmonary hypertension, cor pulmonale
Respiratory distress syndrome
Inhalation exposure
Meconium aspiration syndrome
Pulmonary edema
Pulmonary hypertension, cor pulmonale
Respiratory distress syndrome
Congenital heart disease
Vascular ring
Cardiac tamponade
Congestive Heart Failure (peds)
Myocarditis (peds)
Normal neonatal periodic breathing (misinterpreted by caregivers as abnormal)
Brief resolved unexplained event
Anemia
Abdominal distension (e.g. SBO, liver failure
Neonatal abstinence syndrome
Decreased perfusion states
Pediatric shock
Sepsis (peds)
Dehydration (peds)
Metabolic acidosis
Diabetic ketoacidosis (peds)
Inborn errors of metabolism
Salicylate toxicity
CO Poisoning
Diaphragm injury
Renal Failure
Electrolyte abnormalities
Organophosphate toxicity
Tick paralysis
Fever (Peds)
Panic attack
Porphyria
Pediatric shock
Sepsis (peds)
Dehydration (peds)
Diabetic ketoacidosis (peds)
Inborn errors of metabolism
Salicylate toxicity
Croup
Laryngotracheomalacia
Laryngitis
Accounts for 60%
Sinusitis
Usually exacerbated by viral URI
Epiglottitis
Dx w/ flexible fiberoptic laryngoscopy