Baby Sounds Congested but No Mucus? Causes, Treatments, and More - Healthline

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• Baby Sounds Congested but No Mucus? Causes, Treatments, and More - Healthline
• Morning Cough: Underlying Causes, Diagnosis, and Treatment - Healthline
• Malpractice Case: When an Expert's Opinion on a Cardiac Death Isn't Useful - Medscape

Baby Sounds Congested but No Mucus? Causes, Treatments, and More - Healthline Posted: 17 Dec 2020 12:00 AM PST While the sniffles and snuffles that go along with congestion aren't a medical emergency the first time you hear them from your own baby, it can sure feel like it. Especially if your baby sounds congested but you don't see any boogers or mucus in their nose, it may seem like a problem without a solution. So what's going on with your baby and how do you help them? Healthy babies can often sound congested simply because they're tiny new people with baby-sized systems, including miniature nasal passages. Just like those itty-bitty fingers and toes, their nostrils and airways are extra small. It doesn't take much for these teeny pathways to become affected by minor dryness or by just a bit of clear mucus. This may simply be a normal part of their growth and development. But there are things that can affect the amount of congestion they have, and knowing what those are may help you relieve some of their sniffles with home treatments — or signal when you should call the doctor. Here are some factors that increase the chances of chances of congestion: Preemie babies. The air passages of preemies are even smaller than those of your average newborn. This may make slightly noisy breathing even more likely. Air irritants. Think tobacco or cooking smoke, heavy perfumes, room aromatherapy diffusers, or fumes from household cleaning products, paint, or varnish. These can irritate your baby's nasal passages. Dry air. Low humidity can dry out and irritate nasal passages. This can be a result of using your home's heating system or simply living in an arid climate. Weather changes. Waving goodbye to summer heat may sound like fun, but when the drop in temperature brings low humidity and dry air, your baby is more likely to sound congested. What about illness? Not all congestion is part and parcel of nasal passages that need to grow up. Sometimes, congestion can be related to illness and may even develop deeper in your baby's chest. This congestion can be due to illness such as: Congestion that affects your baby's breathing or moves into baby's lungs may signal a more complex condition such as: Several things can signal that your baby has congested nasal passages. Here's what to look out for: sniffles and snuffles slightly blocked or runny nose noisy breathing snoring when asleep touch of difficulty when feeding light coughing With these light symptoms you, at least, can breathe easy. Look for other signs that may indicate illness, like fever or vomiting, to determine whether to call the doctor. If your baby has any of the following symptoms, you've got some reason for concern: The sniffling turns into labored breathing. You can hear wheezing that makes it sound like each breath is an effort. Your baby's nostrils flare in and out every time they breathe. Your baby's chest retracts with each breath. If your baby is demonstrating any of these symptoms, call the doctor right away. Sometimes your baby may sound congested, but, try as you may, you can't see much mucus. What gives? The first step is to look for any other signs of illness. Does your baby have a fever? Is your baby listless? Have your baby's diapers been sufficiently wet and frequent? Does your baby refuse to breastfeed or reject their bottle? Does their congestion interfere with their sleep? If you see any of these symptoms, talk with your doctor to determine the best treatments to help your baby. On the other hand, if your baby seems generally content and is eating, sleeping, and dirtying diapers regularly, you may not need to do anything but wait for the congestion to pass. In some cases doing too much (like frequent use of a nasal aspirator) can irritate the nose further. If you're looking for a way to help a fussy congested baby, you may want to start with some of the home remedies below. Home remedies to ease congestion You may not see any mucus in your baby's nose, but that doesn't mean it might not be there. Since your baby spends so much time lying on their back, mucus can easily collect in the back of their nose or throat, causing the sniffling you don't want to hear. These home remedies may ease congestion: Warm baths. A calming bath in warm water can help clear congestion. Saline drops. A few saline drops in each nostril can help to loosen and thin the mucus. Thank your lucky stars if your baby sneezes and releases the mucus independently. Nasal bulb syringes or nasal aspirators. If your baby isn't sneezing on their own to clean things out you can clear away the excess mucus mechanically by using a bulb syringe or nasal aspirator. Cool mist humidifier. A humidifier can prevent dry air from irritating your baby's nasal passages. Positioning. Hold or wear your baby, or put your baby in the swing when they're awake so they're spending less time flat on their back. Do not place anything in the crib with your baby to position them as that can increase the risk of sudden infant death syndrome (SIDS). Facial massage. Use your thumb to gently massage the nasal bridge, forehead, temples, and cheekbones. This may help drain the nasal passages. Clean air. Clear away dust, allergens, and pollutants. Clean air and clean surfaces can reduce your baby's exposure to irritants. Throw open your windows and go on a housecleaning spree. While some people may recommend vapor rub, at least one study suggests that it's not the best choice for babies and should be avoided. The same goes for the various cold medications that are available over the counter — stick to the home remedies listed above or consult your doctor about other treatment options. While you'll want to keep an eye out to ensure that nothing else is in the wings, usually a congested nose in your baby is simply part of their growth process. As they get a bit bigger it's likely to simply resolve itself. If you're concerned, check with your baby's pediatrician and discuss whether further treatment is needed.

Morning Cough: Underlying Causes, Diagnosis, and Treatment - Healthline Posted: 02 Dec 2020 12:00 AM PST A morning cough is a relatively common health issue, and there are numerous potential causes. Coughing is your body's way of clearing irritants from your respiratory system. While you sleep, phlegm and other irritants can pool in your lungs and throat overnight. When you become active in the morning, the phlegm starts to break up and may trigger a coughing fit. Often, a morning cough isn't a sign of a serious medical condition. But if it doesn't go away after a few weeks or if it's making breathing difficult, it may be time to see a doctor. Let's examine the potential causes of your morning coughing fits and look at how you can treat them. A cough that produces phlegm is known as a wet cough or productive cough. If it doesn't produce phlegm, it's called a dry cough or unproductive cough. Knowing which type you have can help you narrow down the cause. Common cold The average American has two to three colds per year, and children usually have more. A persistent wet cough is one of the most common symptoms. Many people find their cough is worse in the morning from phlegm that accumulates overnight. Other symptoms of the common cold include: Respiratory infections Respiratory infections are a group of infections that target either your upper or lower respiratory tracts. The common cold and COVID-19 are two of many examples. Like with colds, other respiratory infections also have the potential to increase phlegm buildup overnight that leads to coughing fits in the morning. Along with cold-like symptoms, you may also experience: Allergy Hay fever (allergic rhinitis) is an immune reaction to airborne allergens such as pollen, pet dander, or dust mites. Symptoms can include: Because dust mites tend to live in bedding, people with dust mite allergies usually experience worse symptoms at night and in the morning. Pollen counts are generally highest in the morning and may worsen your cough in the morning if you have a pollen allergy. Postnasal drip Postnasal drip is when your body produces excessive mucus that builds up in the back of your nose and drips into your throat. It's often a symptom of colds, allergies, or eating spicy foods. Symptoms include: a constant feeling of needing to clear your throat a wet cough that's worse at night or in the morning nausea sore or scratchy throat bad breath Bronchitis Bronchitis is inflammation of the bronchial tubes in your lungs and can be either acute or chronic. Acute bronchitis is often caused by the common cold or respiratory infection. Chronic bronchitis is often caused by smoking. Symptoms include: wet cough general cold symptoms chest discomfort slight fever or chills People with bronchitis often find their cough is worse in the morning from phlegm that pools overnight. Asthma Asthma is a chronic condition that causes the airways to your lungs to swell. This swelling can make it difficult to breath. Asthma severity can range from barely noticeable to life threatening. The most common symptoms of asthma include: dry or wet coughing wheezing trouble breathing chest tightness fatigue Many people with asthma have a cough that's worse at night or in the early morning. Chronic obstructive pulmonary disease (COPD) COPD is a group of progressive pulmonary diseases including emphysema and chronic bronchitis. The most common cause of COPD is smoking tobacco. The primary symptoms of COPD are a wet cough and trouble breathing. Other symptoms include: wheezing chest tightness frequent sickness fatigue Late-stage COPD may cause emergency symptoms, such as: bluish lips or gray fingernails from low oxygen levels confusion inability to catch your breath or talk rapid heart rate Symptoms can appear at any time of a day, but in general, people with COPD experience the worst symptoms in the morning. Gastroesophageal reflux disease (GERD) It's thought that more than 25 percent of chronic coughs are caused by GERD. GERD occurs when your stomach acid frequently flows back into your esophagus from your stomach. Symptoms include: chronic cough burning in your chest, often after eating chest pain swallowing difficulty feeling of a lump in your throat GERD commonly causes a cough after eating and when lying down. Some people with GERD may notice their cough is worse in the morning after spending the night lying in bed. A morning cough is frequently paired with other symptoms. Chronic coughing in the morning A chronic cough that lingers may be caused by: COPD asthma allergies to dust mites chronic bronchitis Coughing up blood in the morning Medical emergency Coughing up blood may be a sign of a serious medical issue. You should see a doctor if you see blood in your phlegm. Possible causes include: Coughing at night and in the morning If you're coughing in the morning and evening, it may be caused by: postnasal drip common cold respiratory infection asthma GERD COPD lung cancer Babies can experience morning coughs for many of the same reasons as adults and older children. Potential causes are: If your morning cough doesn't go away after several weeks, you should visit a doctor for a proper diagnosis. You should also see a doctor if you experience: Signs that you should seek emergency medical care include: If you're dealing with a chronic cough, a doctor will likely ask you questions about your medical history. They'll also likely perform a physical exam and listen to your breathing with a stethoscope. The doctor may also order a blood test or send a sample of your mucus to a lab to search for a viral infection. If they expect you may have COPD or asthma, they may measure your lung function with a spirometry test. If none of the previous tests identify the cause of your cough, a doctor might order imaging tests like an X-ray or a CT scan to check for lung cancer, pneumonia, and other lung diseases. They may also consider a scope test called a bronchoscopy to look inside your lungs with a small camera. The best treatment option for your cough depends on the underlying cause. Common cold, respiratory infections, postnasal drip, acute bronchitis There isn't a cure for the common cold or for respiratory infections. Getting plenty of rest will help your body fight the infection faster. Cough medicine can help suppress your urge to cough while decongestants can help manage postnasal drip. Allergy Potential treatments for a cough caused by allergies include: COPD COPD treatment options include: GERD Treatment options for GERD include: There are many potential causes of a morning cough. Often, a morning cough isn't a need for concern. However, if it persists for more than 2 weeks or if you're having trouble breathing, it's a good idea to visit a doctor for a proper diagnosis.

Malpractice Case: When an Expert's Opinion on a Cardiac Death Isn't Useful - Medscape Posted: 07 Dec 2020 12:00 AM PST Virtually all medical malpractice cases turn on expert testimony. If the conflicting testimony by the expert witnesses called by the plaintiff and the defendant meets proper thresholds, a jury will be called on to decide which expert to believe. But not just any words — even those uttered by a well-qualified physician — can get a case to the jury. A plaintiff must prove four prongs to prosecute a claim of medical professional liability: that a duty existed between the defendant healthcare provider and patient; that the healthcare provider was negligent in his or her treatment of a patient; that the patient suffered an injury; and that there was a causal link between that injury and the negligence. The duty and injury components are usually easily met, leaving the bulk of cases to be fought over as a battle between experts. But the last requirement, "causation," can sometimes trip up a plaintiff's case. A 57-year-old man drove to the hospital emergency department at 4:03 AM, complaining of stomach pain and a tight chest. Within 15 minutes, vital signs were recorded, including a pain level of 7 out of 10. A nurse noted the patient's height and weight (including a body mass index of 33.9 kg/m2) and that he complained of neck pain, cough, sore throat, and chest congestion: "like a dull ache in my throat, like I'm getting strangled below my neck." The nurse noted that the patient was alert, was denying any chest pain or shortness of breath, and was speaking normally and ambulating without difficulty. After triage, he was placed in a bed at 4:22 AM. The patient was then evaluated by another nurse whose notes, recorded at 4:59 AM, reflected that the patient was alert, oriented, cooperative, appeared to be in distress from pain, and that he had woken up with pain as if something was "stuck" in his throat. The notes reflect that the patient complained of epigastric pain, that he denied shortness of breath or inability to swallow, but that he said he felt the need to "clear his throat, but when he does, it doesn't clear." The nurse noted no respiratory distress but upper chest pain and a sore throat. At 5:03 AM, the patient was placed on a cardiac monitor, and notes at 5:46 AM show that an IV site had been established and drawn specimens sent to the lab. Dr ER1, an emergency specialist, evaluated the patient at 5:10 AM and ordered an ECG, which he reviewed at 5:34 AM. A radiologist read a chest x-ray ordered by Dr ER1 as showing "no radiographic evidence of acute cardiopulmonary disease" but "mild cardiomegaly." Another nurse took over the patient's nursing care at 6:19 AM, and notes of that care showed vital signs and that the patient was "standing at bedside for comfort." Dr ER2 took over from Dr ER1 at around 6:00 AM, and records show that over the next several hours, various tests were performed, including another ECG, two troponin tests, and other blood work. In his testimony later, Dr ER2 said that although he had no independent memory of treating the patient, it was his custom and practice to look at electronic records to see if a patient had been treated at the hospital previously. Also, according to his custom and practice, he would have looked at any previous discharge summaries and old ECGs, and would have talked to the patient. At 11:00 AM, Dr ER2 decided to discharge the patient after seeing him a second time and "improved." Serial vital signs throughout the morning were normal and stable, and the patient's pain had reduced to 4 out of 10. Dr ER2's discharge included a diagnosis of "chest pain of unclear etiology," a referral of the patient to a cardiologist, and instruction to follow up with his primary care physician in 1 day. Less than 8 hours after discharge, the patient died of an acute dissection of the aorta.

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