Medical Mnemonics

Pediatric Stridor Causes Mnemonic: “C.H.A.I.L.D”

June 1, 2025

Let me set the scene:

One cold winter night in Quetta, I had just finished a long CCU shift (where Dr. Imran Baloch was lecturing a resident about left ventricular outflow gradients) when I got pulled into Pediatrics. A nurse from our outreach camp in Mashkel, Balochistan brought in a two-year-old with inspiratory stridor loud enough to make a wheezing bagpipe blush. 😬

Panic in parents’ eyes.
Confusion on the intern’s face.
And me, whispering under my breath: “Let’s C.H.A.I.L.D. this.”

Before we dive into this mnemonic, let’s first understand the basics:

Table of Contents

🧠 Why Is Pediatric Stridor Important?

Stridor = upper airway obstruction

In children, the airway is already the size of a drinking straw — add swelling, foreign bodies, or anomalies, and you get noisy breathing that can quickly turn deadly. Knowing the common causes — and how to think through them fast — is vital.

Pediatric Stridor Causes Mnemonic

Letter	Cause	Clinical Pearl
C	Croup	Barking cough + steeple sign on X-ray
H	Hypocalcemia (laryngospasm)	Think of tetany, especially post-thyroid surgery or in neonates
A	Airway foreign body	Sudden onset, localized wheeze, may be misdiagnosed as asthma
I	Infections (epiglottitis, abscess)	Drooling + tripod position = RED FLAG
L	Laryngomalacia	Inspiratory stridor in neonates, worsens when supine
D	Diphtheria	Rare but deadly; look for greyish membrane + unvaccinated child

🩺 Real-Life Case: The Baby from Mashkel, Balochistan

This particular toddler had barking cough, low-grade fever, and inspiratory stridor worse at night. An over-enthusiastic paramedic had tried salbutamol (which helped nothing), and the mother, in pure Baloch style, had used salted goat milk with ajwa dates. 😅

We suspected croup, confirmed with a neck X-ray (hello, steeple sign 📸), and started nebulized epinephrine + dexamethasone. The child improved within hours — no bronchodilators were harmed in this case.