1 - Paeds - Resp - ENT - Epiglottitis Flashcards
acute epiglottitis is a…
caused by? most common in who?
life threatening emergency due to risk of airway compromise
Hib
mostly 1-6y but affects all ages
what must you not do to a pt with epiglottitis
do not lie down or examine - may distress pt and cause respiratory arrest
Symptoms of epiglottitis
high fever
ill looking child
throat pain preventing speech/swallow - drooling
minimal/no cough (vs croup)
signs of epiglottitis
intense swelling of epiglottis and surrounding tissue
VERY ACUTE onset
soft inspiratory stridor
RAPIDLY worsening resp difficulty- over hours
what may a child with epiglottitis look like
immobile
sat upright/leant forward
open mouth to optimise airway
look very ill
who to summon if suspected
senior anaesthetist, paeds and ENT surgeon
what happens once suspected and relevant people arrive
transfer to ICU/anaesthetic room in case of arrest, intubate under GA, if impossible -> tracheostomy
what happens once the airway is secured
blood cultures and IV ABx started (cefuroxime)
when remove tracheal tube? ABx for how long? recovery time? what given to household contacts?
remove tube after 24h
ABx for 3-5d
most recover after 2-3d
rifampicin to household contacts
Croup vs Epiglottitis
- onset
- preceding cold
- cough
- able to eat and drink
- drooling
- appearance
- fever
- stridor
- voice and cry
CROUP
- days
- yes
- severe, barking
- yes
- no
- unwell
- <38.5
- harsh, rasping
- hoarse
Epiglottitis
- over hours
- no
- absent/slight
- no
- yes
- toxic
- > 38.5
- soft,whispering
- muffled, reluctant to speak
