Epiglottitis

treatment / management continued

- transfer pt to ICU -sedate if necessary -place on T-piece or CPAP -oxygen therapy -drug therapy 1) antibiotics

Criteria for Extubation

-child's condition is stable - swelling in the airway has diminished

side noted to remember

1) avoid any unnecessary stimulation of the child 2) diagnosis should be made at the bedside

Primary patient Assessment: Physical Appearance

2-6 years of age, lifeless, drooling, hoarseness, inspiratory stridor, difficulty swallowing (dysphagia), tongue thrusts forward during inspiration, voice and cry muffled, jaw jutted forward

secondary Assessment: ABG

Acute alveolar hyperventilation with hypoxemia

Primary patient Assessment: Breath Sounds

Diminished, inspiratory stridor

secondary Assessment: Lateral Neck X-Ray

Haziness in the supraglottic area (epiglottis), supraglottic swelling (above the glottis) or Thumb sign

Primary patient Assessment: Appearance of chest

Substernal and intercostal retractions

Primary patient Assessment: Past medical history

Sudden onset within 6-8 hrs

Primary patient Assessment: Respiratory pattern

Tachypnea

secondary Assessment: CBC

elevated WBC

Primary patient Assessment: Vital signs

high fever (measured axillary or tympanic to avoid stimulating the child), increased HR, BP, cardiac output

Treatment/management

immediate placement of an artificial airway 1) ETT 2) Tracheostomy if unable to intubate

Primary patient Assessment: cough

muffled cough

Primary patient Assessment: color

pale or cyanosis

what is epiglottis?

potential airways emergency caused by inflammation of the supraglottic structures (epiglottis, aryepiglottic folds, and false vocal cords) just above the vocal cords. Most often a bacterial infection caused by Haemophilus influenza B