Epiglottitis
Definition
The epiglottis is a flap of tissue covering the opening of the larynx to keep out the food and fluid from entering the respiratory tract. Epiglottitis is the inflammation and the infection of the epiglottis. It is a rare case, however, epiglottitis is an emergency condition as the swollen epiglottis cannot rise and allow the airway to open.
Frequency
- The inflammation of epiglottitis occurs most frequently in children from 2 to about 7 years of age.
Cause
Epiglottitis can either be bacterial or viral in origin. The following causes the occurrence of this condition:
- H. influenzae type B
- Pneumococci
- Streptococci
- Staphylococci
- Echovirus
- Respiratory syncytial virus
Signs and Symptoms
- Severe inspiratory stridor
- High fever
- Hoarseness or voice
- Sore throat
- Difficulty swallowing or dysphagia
- Drooling
- Tongue protrusion to increase free movement in the pharynx
- Throat – seen as a cherry-red structure and edematous
- Muffled cough
- Leukocytosis
- Cyanosis – severe cases
Management
- Moist air to reduce the epiglottal inflammation.
- Oxygen if cyanosis is present.
- Antibiotic therapy such as a second-generation cephalosporin – CEFUROXIME.
- The antibiotic such as Cefuroxime may be prescribed to the patient for a full 7 to 10 days. After the antibiotic therapy the epiglottal inflammation recedes rapidly.
- To maintain hydration in patients with epiglotitis, intravenous fluid therapy is needed since these children cannot swallow.
- It is important that the nurse should prepare a tracheostomy or entracheal intubation set at the bedside. Children with epiglotitis may need a prophylactic tracheostomy or necessitate endotracheal intubation to prevent total airway obstruction.
- IMPORTANT REMINDER: Never attempt to visualize the epiglottis directly with a tongue depressor because the gagging procedure causes complete obstruction of the glottis and results to respiratory failure.
- Throat culture should NOT be done UNLESS a means of providing an artificial airway such as a tracheostomy or endotracheal intubaton is readily available.
image courtesy of mountnittany.org
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
