Epiglottitis

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Ashley Powell
MSN,RN,PCN
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Included In This Lesson

Study Tools For Epiglottitis

Epiglotitits (Image)
Epiglottitis Pathochart (Cheatsheet)
Hypoxia – Signs and Symptoms (in Pediatrics) (Mnemonic)
Epiglottitis – Signs and Symptoms (Mnemonic)
Epiglottitis Assessment (Picmonic)
Epiglottitis Interventions (Picmonic)

Outline

Overview

  1. Inflammation of the epiglottis
  2. Caused by Haemophilus influenzae type B

Nursing Points

General

  1. Inflammation can restrict airway
  2. Considered a medical emergency
  3. Hib vaccine has reduced the incidence and risk

Assessment

  1. Fever
  2. Difficulty swallowing = drooling
  3. Stridor = high pitched upper airway noise
    1. Sign of airway obstruction
    2. Medical emergency
  4. Absence of cough
  5. Tripod positioning
    1. In attempt to ease effort of breathing
  6. Irritability
  7. Change in level of consciousness
  8. Cherry red  throat

Therapeutic Management

  1. IV Antibiotics
  2. Oxygen (humidified)
  3. May require invasive ventilation
  4. Nursing care
    1. Do not leave the child
    2. Call for emergency airway equipment
    3. Keep child calm and comfortable until emergency airway equipment is available.
    4. Things to avoid – (Can cause spasms and cause complete airway obstruction)
      1. Irritating the child
      2. Assessing the throat
      3. Use of tongue depressors
      4. Use of oral thermometers
  5. Maintain NPO
  6. Positioning
    1. Avoid supine positioning which can further restrict airway.  
    2. Tripod position is usually most comfortable
  7. Administer oxygen as ordered
  8. Administer antibiotics as ordered
  9. Ask parents if their child has had the Hib vaccine

Nursing Concepts

  1. Oxygenation
  2. Infection Control

Patient Education

  1. Educate parents when to call 911
  2. Non-Pharmacological options to relieve shortness of breath

[lesson-linker lesson=221486 background=”white”]

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Transcript

Hey guys! In this lesson, we are going to be talking about the diagnosis epiglottitis.

Okay, so epiglottitis is a medical emergency! It is severe inflammation of the epiglottis, which is located just here in the back of the throat. It’s usually caused by Haemophilus Influenzae Type B and usually occurs in kids 1-7 years of age. There is a vaccination for this so we are seeing fewer cases of epiglottitis.

I’ve listed the 4 most important symptoms to be on the lookout for over here on the left. They are stridor, drooling, absence of cough, and tripod positioning. So stridor is a sound made in the upper airway that is high-pitched and frog-like and usually occurs when there is an airway obstruction.

Drooling is also a sign of airway obstruction. The patient has difficulty swallowing and ends up drooling.

These kids also tend to be quiet, so they don’t have a cough. This is very different than other respiratory illnesses like croup.

Remember, I said this is medical emergency, these kids are struggling to breath because their airway is closing. So they will likely be sitting in a tripod position, leaning forward with their mouth open. They are trying their best to keep that airway open by sitting this way.

Epiglottitis usually causes a high temperature, and again this is different than croup which usually has a lower grade temp.

These kids are usually irritable and lethargic and the epiglottis, if you looked at it, would be cherry red and inflamed. But, and this is super important guys, it’s imperative that you do not look at the throat or put anything into their mouth like a thermometer or a tongue depressor. This could cause a spasm which could close the airway completely.

The most important thing to remember for this medical emergency is that this child should only be treated if there is emergency airway equipment readily available. So if it isn’t, you need to call for it and until it arrives keep the child calm and comfortable. Upsetting the child can, again, cause a spasm that would occlude the airway completely.

So this kid needs oxygen applied and they need IV antibiotics given as quickly as possible to treat the Haemophilus Influenzae Type B.

Depending on the severity of occlusion, the child may need invasive ventilation.

Your priority nursing concepts for a patient with epiglottitis are oxygenation, infection control and health promotion.
Alright that’s it for our lesson on epiglottitis, lets go over the key points! First, it is a medical emergency because the epiglottis is inflamed and can obstruct the airway. So, you’ve got to make sure emergency airway equipment is available.

It’s usually caused by Haemophilus Influenzae Type B. There is an immunization for this so this is an important point for health promotion and prevention in kids.

The classic symptoms for epiglottitis are stridor, drooling, lack of cough and tripod positioning.

Make sure to avoid upsetting the child and don’t assess the throat! This can cause a spasm and full obstruction.

Treatment is obviously about supporting and maintaining the airway, but they really really need IV antibiotics to treat the cause of the inflammation.

That’s it for our lesson on epiglottitis. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!

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