Secretions
Presentation: Gurgling, crackling, or rattling sounds with breaths. Can worsen dyspnea or cough, and be distressing to caregivers.
Non-pharmacologic management:
Support/education (often more distressing to parents than patient)
Reposition
Minimize suctioning
Decrease fluids
Pharmacologic management:
Anticholinergic medications: monitor for dry mouth, urinary retention, or constipation
| Drug | Dosing |
|---|---|
| Glycopyrrolate |
PO: 0.04 - 0.05mg/kg q4-8h IV: 0.004 - 0.005mg/kg q3-4h |
| Atropine 1% eye drops | 1-2 drops q4-6h prn SL and titrate to effect |
| Scopolamine patch |
0.33 - 0.5mg TD q24h 1.5mg q72h |