epiglottitis

what is epiglottitis?

swelling and inflammation of the epiglottis - life threatening emergency as can obstruct airway

what is epiglottitis generally caused by?

haemophilus influenza type B

why is epiglottitis rare nowadays?

vaccination programme - part of the 6 in 1 you get at 2,3,4 months

how does epiglottitis present?

similar to croup by onset is quicker:

- sore throat and stridor

- drooling

- tripod position

- high fever

- difficulty or painful swallowing

- muffled voice

- scared and quiet child

- septic and unwell appearance

should investigations be performed if patient is acutely unwell and epiglottitis is suspected?

no

how is epiglottis diagnosed?

DIRECT VISUALISATION - by a senior/airway trained clinician

why should examining the throat be avoided if possible?

risk of acute airway obstruction

what investigation could be done for epiglottitis?

lateral neck xray

what would the lateral neck xray show?

thumb or thumbprint sign

what is the thumb sign?

soft tissue shadow looks like a thumb pressed into trachea - cause by a swollen and oedematous epiglottis

who should be alerted in acute epiglottitis?

senior paediatrician and anaesthetist

what does the management of epiglottis centre around?

ensuring the airway is secure - may require:

- endotracheal intubation

- tracheostomy

what are the additional treatments once the airway is secure?

- IV antibiotics - cerftiaxone

- steroids - dexamethasone

what is the most common complication of epiglottitis?

epiglottic abscess - life threatening emergency