Acute Epiglottitis Flashcards
What is epiglottitis?
Inflammation and swelling of the epiglottis
What type of condition is epiglottitis?
It is a life threatening emergency.
Who does epiglottitis tend to affect?
Most common in 1-6 year olds
What is the main cause of epiglottitis?
Haemophilus influenza type B
What are the main features of epiglottitis?
- rapid onset
- high temperature, generally unwell
- immensely painful sore throat when speaking or swallowing
- inspiratory stridor
- drooling of saliva
- absent cough
What are the 3 main presentations?
- inspiratory stridor
- drooling of saliva
- absent cough
What position does the patient tend to adopt and why?
‘tripod’ position: the patient finds it easier to breathe if they are leaning forward and extending their neck in a seated position
What investigations would you do in an acutely unwell patient with suspected epiglottitis?
No investigations
What investigation might you do if you were unsure if it was epiglottitis?
Chest x-ray /neck x-ray
What would a lateral x-ray show?
“thumb sign” or “thumbprint sign”- oedematous and swollen epiglottis.
What would a posterior x-ray show?
Subglottic narrowing- ‘steeple sign’
What can you exclude with a neck x-ray?
Foreign body
What is the initial management of acute epiglottitis?
Secure the airway- Endotracheal intubation
What would you do when the airway is secure?
Take cultures and examine the throat.
What is the medical management of acute epiglottitis?
IV antibiotics- IV cefuroxime
