Epiglottitis: Difference between revisions
| Line 30: | Line 30: | ||
*Steroids | *Steroids | ||
**Methylprednisolone 125mg IV | **Methylprednisolone 125mg IV | ||
*Intubation or cricothyrotomy | *[[Intubation]] or [[cricothyrotomy]] | ||
==Disposition== | ==Disposition== | ||
Revision as of 06:02, 27 February 2014
Background
- Otolaryngologic emergency
- Can lead to rapid onset of life-threatening airway obstruction
- Most cases are seen in adults (since advent of H. flu vaccine)
- Etiology
- Strep, staph, H. flu (unvaccinated)
- Caustic burns
Clinical Features
- Three D's:
- Drooling
- Dysphagia
- Distress
- Pain with gentle palpation of larynx and upper trachea
- Stridor
- Respiratory distress
Diagnosis
- Imaging only required if diagnosis uncertain
- Lateral neck x-ray
- Obliteration of vallecula
- Edema of prevertebral and retropharyngeal soft tissues
- "Thumb sign" (enlarged epiglottis)
Treatment
- Emergent ENT consult
- O2 (humidified)
- IVF (hydration minimizes crusting in the airway)
- Ceftriaxone 2gm IV
- Steroids
- Methylprednisolone 125mg IV
- Intubation or cricothyrotomy
Disposition
- Admit
Source
Tintinalli