Epiglottitis Flashcards
What is epiglottitis?
Epiglottitis is the potentially, life-threatening inflammation of the supraglottic structure, occurring, primarily, as a result of a bacterial infection (Caroline,2013).
What are the signs and symptoms of epiglottitis?
The signs and symptoms of epiglottitis will be those of someone with significant difficulty breathing and significant difficulty swallowing. So, you would expect to see an obviously sick child who appeared scared or worried trying to increase their air intake by sitting upright, head tilted back as if sniffing the air, working hard to breathe and possibly drooling due to a difficulty in swallowing saliva. Pallor or cyanosis may also be apparent due to poor perfusion of the skin. The disease progresses rapidly so only a matter of hours earlier, the child will have been suffering from a high fever and sore throat (Caroline, 2013).
What is the aetiology of epiglottitis?
The primary bacterium responsible for the disease was Haemophiis influenza type B (Hib) and the age group that was most commonly affected were the 2 to 4 year olds. However, thanks to the Hib vaccine the disease is now rare. One review of the disease showed an incidence of 0.6 per 100,000 in the United Kingdom. A study of the incidence of the disease in Denmark showed an average of 4.9 cases per 100,000 in the decade preceding vaccination. After vaccination (1996-2005) the incidence dropped to 0.02 cases per 100,000. The prognosis is good for patients with epiglottitis whose airways have been secured. The mortality rate is less than 1% in these patients. However, mortality rates as high as 10% can occur in children whose airways are not protected by endotracheal intubation (Medscape, 2013).
What is the pathophysiology of epiglottitis?
Respiratory transmission of bacteria through close contact with infected children can lead to the start of the disease. Inflammatory oedema will start on the lingual side of the epiglottis and can rapidly spread to affect the aryepiglottic folds, arytenoids soft tissue and, rarely, the uvula. The epiglottis is, most commonly, the location of the swelling. Airway obstruction through inflammation, aspiration of oropharyngeal secretions, or distal mucous plugging can cause respiratory arrest (Tolan, 2013).
What is the treatment for epiglottitis in children?
NB ask about immunisation in history. Due to the complex differences in the child’s airway, intubation and advanced airway management should only be performed by a skilled and competent paramedic/clinician. A short narrow trachea, posterior placed epiglottis and narrowing at the cricoid ring makes intubation extremely difficult and can cause significant oedema and further compromise to the airway if not performed correctly (Blaber, 2011). The aim would be to get the child to definitive care as quickly as possible due to the risk of rapid deterioration leading to respiratory arrest. Keep the child as calm as possible, do not attempt to look into the mouth as this could severely exacerbate the situation (Caroline, 2013). Give supp O2 only if tolerated! Position of comfort as per croup.
What is the epidemiology of epiglottitis?
Affects all age groups but most common in 1-6 year old.
Year round occurence.
