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