LIKE ON FB

Tuesday, January 12, 2010

common cold: Treating running nose!

common cold: Treating running nose!
caring for kids, their health and illness: Child health specialist pediatrician Mumbai
Treating running nose is no big deal... but treating its complications and PNDrip (postnasal drip) is a headache for the practitioner. In fact, I had seen pediatricians admitting and sedating for 3 days to get rid off. combination decongestants for patient and family.

tricks:

Running nose:

A very common problem; watery or thick.. continuous or intermittent..
with fever or without fever, yellow white.. (pardon the allergic once, they come with paroxysmal sudden sneezing and are more easy to treat... oral atihistaminics or nasal antihistaminics and or steroid inhalors.. but you too pls do read below)

watery or thick.. :


Clean nostrils with ear buds/bulb ( no ENT will advice, but i do, by cleaning I mean cleaning the alae nasae- the outer part), periodically, if its thicker.. use saline drops (nasomist spray) : no of drops + no of months of age till 8 months.. then 10 drops for all, wait 2 seconds after each drop.. then clean with ear buds once the drops are over. why more drops? - Bcos you want to douche the whole nasopharynx and clean the nose; the sticky secretions along nasopharynx will be dragged to oropharynx and then swallowed.
If its running continuously, one may prefer putting decongestant nasal drop like flucold drops.. or nasovion mini drops, ( i will avoid xylometazoline and oxymetazolien drops in children as much possible ) use only 2 to 4 drops at any age.. nose will dry within 20 minutes provided drops are put after drying the nose with ear buds.. small dose bcos we want local action. Dont keep it TDS ( 3 times a day), can be used SOS (as and when required). TDS use makes nose dry.. and the worst nose block will happen and child will be very irritable crying refusing to feeds etc. (discuss with your doc in details).


Treatment of noseblock:

commonest cause; inadvertant or TDS use of decongestant or sleeping in front of / facing fan.... stuffy nose.
Treatment:
saline drops: I use nasomist /normal saline drops/spray procedure as above. But keep it TDS, keep nose wet, avoid drying by air/drugs. Stop decongestant drops. If child is cranky, do a mechanical nasal suction tiding over the crisis.. the thick secretions may be difficult to suck by syringe. Give A soothing nebulisation following suction, Clinical indicator: Irritability settles, child sleeps.

Treatment of Any of above with fever ; with or without PND: combination cold syrups
Add a simple antipyretic, paracetamol: regular dose, round the clock for 2 days. If running nose, give combination with decongestant TDS orally, I find syp xxxx more effective. (though many parents complain that the taste isnt good.. let me teach you feeding medicines without having taste of it)
For PND: a good saline nebulisation with prior nasal suction and saline drop wash of nose. continue oral PCM and decongestant drops combination for 3 days.
At times a short course chemotherapy with azithromycin may help if it lasts more than 72 hrs.

The risk in any common cold or flu is the chance of it spreading down to cause bronchitis or pneumonia or bronchiolitis, though not so common. keep a watch on refusal to feed , breathless ness and worsening cough. Discuss with your doc accordingly regarding further plan.           

Persistant runny nose for more than 10 days.. suspect adenoids.
Unilateral runny nose is often due to foreign body in nose or sinusitis.
Stuffy nose with headache is due to sinusitis/allergy very often.
Runny nose with itching .. and eye itching.. is allergic, if it is aproxysmal and sudden.
Throat pain, ear pain may be a part of bacterial complications.
PND may cause burning in throat and best tackled by gargling and nebulisation.