The epiglottis is the flap of cartilage that covers the trachea when swallowing that blocks airflow and prevents food from entering the lungs. When the epiglottis swells, it can completely block the airway and become life-threatening. Swelling can occur quickly and requires immediate intervention.
The most common cause of epiglottitis is bacterial infection, specifically Haemophilus influenzae type b (Hib) and Groups A and C streptococci. In some cases, a bacterial superinfection that causes epiglottitis may be the result of a previous viral infection such as varicella-zoster or Epstein-Barr virus. Viruses usually do not cause epiglottitis on their own. Thermal or chemical injuries, burns from hot liquids or direct trauma may also cause epiglottitis.
Patient will have adequate airway clearance; patient will maintain body temperature within normal limits and be free from complications
Assess breathing pattern.
See if patient is in respiratory distress to determine treatment; obstruction may require intubation or tracheostomy.
Stridor indicates advanced progression of disease and requires emergency airway management
Position patient sitting up and leaning forward; encourage mouth breathing
This position helps airflow and reduces effort required for breathing, thus minimizing edema
Assess vitals for fever, tachypnea, tachycardia
Fever may indicate underlying cause of condition if related to a bacterial infection
Monitor oxygen saturation and administer humidified oxygen
Oxygen saturation below 90% indicates decreased perfusion and requires advanced treatment.
Humidified oxygen help prevent drying of the mucous membranes and encourages thinning of secretions for easier removal
Maintain NPO status
To prevent choking and further airway obstruction
Initiate IV fluids
To maintain hydration, as well as thin and loosen secretions.
Administer medications by IV route
Prepare patient and equipment for intubation and/or tracheostomy
To maintain adequate ventilation, patient may require tracheostomy or intubation with mechanical ventilation until swelling subsides.
Provide education for patient and parents / caregiver regarding treatment and prevention
Hib is the most common infectious cause of epiglottitis and can be prevented with routine immunizations.
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