Epiglottitis

 

 

Bacterial Infection

Epiglottitis is a emergency medical condition in which the epiglottis, a flap of tissue that prevents food and liquid from entering the windpipe during swallowing, becomes inflamed and swollen. This can result in a blocked airway, making it difficult to breathe. Most commonly caused by a bacterial infection, but can also result from a viral infection or injury to the throat.  Organisms: Haemophilus Influenzae typbe B and Streptococcus pneumoniae.

Tripod position to keep airway open
HIgh fever & difficulty swallowing
Severe: Cyanosis, hypoxia & death

Symptoms

  • High fever
  • Sore throat
  • Cherry red epiglottis
  • Difficulty swallowing
  • Painful swallowing
  • Absent of cough
  • Drooling
  • Muffled voice
  • Rapid breathing
  • Stridor (a harsh, raspy sound when breathing)
  • Cyanosis if airway is obstructed
  • Anxiety 
  • Restlessness
  • Tripod position with chin thrusted forward and mouth open to keep airway open
  • Severe: hypoxia, hypercapnia, tachycardia, ↓ LOC
  • Sudden death
Very sick child. Medical Emergency

Treatment

  • Maintain airway
  • Assess respiratory status
  • Monitor temperature. DO NOT DO ORAL TEMPERATURE
  • No throat culture. Avoid inspecting epiglottis
  • NPO with IV fluids
  • IV antibiotics followed by oral once swelling is reduced
  • Corticosteroids may be used
  • Acetaminophen for fever
  • Have tracheostomy/intubation tray at the bedside
  • Maintain calm/quiet environment
  • Make sure children have Haemophilius influenzae type B (Hib) vaccine to prevent epiglottitis
Have intubation/tracheostomy tray at the bedside
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