may rapidly lead to
fatal airway obstruction
number 1 bug
H flu
what has reduced incidence in children
H flu vaccine
most cases occur in which age group
adults
other pathogens other than H flu that can cause this =
staph and strep
immunocompromised people are at risk of getting this bc of…
pseudomonas aeruginosa and candida albicans
non infectious causes
thermal or caustic burns
direct trauma
foreign body ingestion
presentation in peds
abrupt onset
fever
drooling
sore throat
muffled hot potato voice
tripoding
stridor
resp. distress
NO COUGH
patient general appearance
toxic appearing (look sick)
do symptoms progress rapidly
yes
increased incidence in what populations
unvaccinated
really important to leave patient in what condition?
condition of comfort
bedside lateral xray reveals
thumb sign
if unable to move patient what xray can you do
portable soft tissue neck xray
direct visualization and intubation has to be done where
in the OR
presentation in adults
indolent (DEVELOPS SLOWLY NOT SUDDENLY)
1-2 day hx of progressive sore throat
dyspnea
dysphagia and odynophagia
MAY have muffled hot potato voice
fever
cervical adenopathy
hyoid bone tendness
gen appearance of adult
not toxic but sicker than normal pharyngitis
for throat exam for adult what will you see
will be unremarkable but pain is out of proportion ot exam
management
airway stability, hemodynamic stability, IV ANTIBIOTICS LIKE CEPHALOSPORIN, ICU monitoring, when in doubt INTUBATE
what cephalosporin will you give
IV ceftriaxone (3rd gen)
and consider mrsa coverage
close contacts to someone with epiglottitis should received
oral rifampin
what is controversial in treatment
corticosteroids
what has not proven to be helpful and may exacerbate airway compromise in children
racemic (nebulized) epi and inhaled beta agonists
pitfalls
1 = underestimating the potential for sudden deterioration
- rushing intubation without proper anesthesia/support
- performing unnecessary medical procedures before the airway is protected that result in agitation and respiratory collapse
