Acute epiglottis: management

Question 1

What should be done if acute epiglottitis is suspected?

Answer 1

If acute epiglottitis is suspected, urgent hospital admission to the intensive care unit and treatment are required.

Question 2

What is the first step in managing acute epiglottitis?

Answer 2

The first step in managing acute epiglottitis is to secure the airway.

Question 3

What should not be done when managing a patient with suspected acute epiglottitis?

Answer 3

Do NOT examine the throat in a patient with suspected acute epiglottitis.

Question 4

What is the most common approach to securing the airway in acute epiglottitis?

Answer 4

Direct rigid laryngoscopy and intubation is the most common approach to securing the airway in acute epiglottitis.

Question 5

What diagnostic test should be performed in acute epiglottitis?

Answer 5

A blood culture should be taken in acute epiglottitis.

Question 6

What type of antibiotics should be started for acute epiglottitis and for how long?

Answer 6

Start IV 2nd or 3rd generation cephalosporins (e.g. ceftriaxone) for 7-10 days.

Question 7

When should supplemental oxygen be considered for a patient with acute epiglottitis?

Answer 7

Supplemental oxygen should be considered if the patient is stable without any signs of impending airway compromise.

Question 8

What medications may be used to reduce inflammation in acute epiglottitis?

Answer 8

Steroids and adrenaline may be used to reduce inflammation in acute epiglottitis.

Question 9

What may be necessary in severe cases of acute epiglottitis?

Answer 9

Prolonged intubation may be necessary in severe cases of acute epiglottitis.

Question 10

How long does it typically take for most children to recover from acute epiglottitis with appropriate treatment?

Answer 10

With appropriate treatment, most children will recover completely within 2-3 days.

Question 11

What medication should be given once a patient with acute epiglottitis is stable and extubated?

Answer 11

Once stable and extubated, oral co-amoxiclav should be given.

Question 12

What prophylactic treatment should be given to close contacts of a patient with acute epiglottitis?

Answer 12

Rifampicin prophylaxis should be given to close contacts of a patient with acute epiglottitis.

Question 13

acute epiglottis management summary

Answer 13

Acute Epiglottitis
 If acute epiglottitis is suspected, urgent hospital admission to intensive care unit and treatment are required
Management
 Secure airway, do NOT examine the throat
o Direct rigid laryngoscopy and intubation is the most common approach
 Take a blood culture
 Start IV 2nd or 3rd generation cephalosporins (e.g. ceftriaxone) for 7-10 days
 Consider supplemental oxygen if stable without any signs of impending airway compromise
 Consider steroids and adrenaline may be used to reduce inflammation
 In severe cases, prolonged intubation may be necessary
 With appropriate treatment, most children will recover completely within 2-3 days

 Once stable and extubated, give oral co-amoxiclav
Prophylaxis
 Rifampicin prophylaxis to close contacts (most common causative organism is Haemophilus
influenzae type B, so you want to make sure that the antibiotic has good gram-negative coverage)