Acute Epiglottis

Description

PANCE FCM I (1. Respiratory Diseases (Infectious Disorders) Mind Map on Acute Epiglottis, created by Kiley Whalen on 16/06/2021.
Kiley Whalen
Mind Map by Kiley Whalen, updated more than 1 year ago
Kiley Whalen
Created by Kiley Whalen over 3 years ago
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Resource summary

Acute Epiglottis
  1. Pathophysiology
    1. H. influenzae

      Annotations:

      • Unvaccinated populations
      1. Streptococcal sp.
        1. S. aureus
          1. Cocaine
          2. Diagnostics
            1. Laryngoscopy
              1. Thumb Print Signs

                Annotations:

                • Soft tissue lateral cervical radiographs: thumb or thumbprint sign (swollen, enlarged epiglottis)
              2. Risk Factors
                1. Unvaccinated
                  1. Cocaine use
                    1. Diabetics
                    2. Presentation

                      Annotations:

                      • Odynophagia out of proportion to apparently minimal oropharyngeal findings or rapidly developing sore throat
                      1. The 3 D's
                        1. Dysphagia
                          1. Drooling
                            1. Distress
                            2. Ondynophagia

                              Annotations:

                              • Fever, inspiratory stridor, dyspnea, hoarseness, muffled “hot potato” voice, tripoding
                              1. Cherry Red Epiglottis

                                Annotations:

                                • Swollen
                              2. Management
                                1. Maintain Clear Airway

                                  Annotations:

                                  • Keep the patient calm Continuous monitoring of O2 saturation
                                  1. Dexamethasone

                                    Annotations:

                                    • For airway edema
                                    1. Hospitalization with IV Abx

                                      Annotations:

                                      • Hospitalization with IV abx  - Second or third gen cephalosporin - Penicillin, ampicillin, or anti-staphylococcal coverage may be added
                                      1. Corticosteroids

                                        Annotations:

                                        • tapper use as signs and symptoms resolve
                                        1. Indication to Intubate

                                          Annotations:

                                          • Dyspnea, rapid pace of sore throat where airway may close before effects of abx or corticosteroids kick in, endolaryngeal abscess on CT
                                          1. 10 day course of abx may be appropriate
                                          2. Prevention
                                            1. Rifampin given to all close contacts
                                              1. Hib Vaccine
                                              2. Prognosis
                                                1. Adults

                                                  Annotations:

                                                  • Prognosis of adults with acute epiglottitis is good with appropriate and timely treatment. Most pts can be extubated within several days.
                                                  • Unrecognized epiglottitis may rapidly lead to airway compromise and resultant death
                                                2. Complications

                                                  Annotations:

                                                  • Meningitis, epiglottic abscess, cervical adenitis, vocal granuloma, subsequent necrotizing fasciitis of the head and neck (rare), cartilaginous metaplasia of the epiglottis, pna, pulmonary edema, empyema, ptx, pneumomediastinum (rare), pericarditits, septic arthritis, cellulitis, septic shock, death (via asphyxiation)
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