6 - ENT - Upper airway - Obstruction - Acute epiglottis + Laryngeal trauma

Question 1

Laryngeal trauma - look for what?

Answer 1

neck bruising, surgical amphysema - indicates breach of airway, cartilage deformity

Question 2

Laryngeal trauma - treatment

Answer 2

ABs to prevent perichondritis

Intubation/tracheostomy

Question 3

Acute epiglottitis - affects who? how severe? what is it? nature of onset/progression?

Answer 3

affect children and adults
infl of epiglottis, often extending to larynx
rapid onset + progression

Question 4

Causes of acute epiglottitis

Answer 4

Haemophilus influenza type B, strep pyogenes

Question 5

Features of acute epiglottitis

Answer 5

sore throat
drooling
hoarse/muffled voice
stridor
sitting forwards

COUGH USUALLY ABSENT
SYSTEMICALLY UNWELL

Question 6

Acute epiglottitis - do not ..???

Answer 6

examine throat
send for Xrays
cannulate
RISK OF FURTHER DISTRESS AND RESP ARREST

Question 7

Acute epiglottitis - first things to do?

Answer 7

Oxygen by mask - until anaesthetist and ENT surgeon arrive

Question 8

Acute epiglottitis - then?

Answer 8

IV dexamethasone
nebulised adrenaline
intubation
IV PENICILLIN AND CEFTRIAXONE

also blood and epiglottis cultures + antipyretic