What are the approach considerations in the treatment of epiglottitis?

Updated: Apr 28, 2020
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Avoid agitating the patient with acute epiglottitis. Let the patient take a position in which he or she feels comfortable.

Orotracheal intubation may be required with little warning. Equipment for intubation, cricothyroidotomy, or needle-jet ventilation should be made available at the bedside.

Avoid therapy such as sedation, inhalers, or racemic epinephrine.

Administer supplemental humidified oxygen if possible, but do not force the patient, as the resultant agitation could worsen the condition.

Clinical pitfalls include the following:

  • Underestimating the potential for sudden deterioration (most common error)

  • Inadequate monitoring in which deterioration goes unnoticed (second most common error)

  • Rushing intubation without proper support (ensure the availability of an anesthesiologist or other individual experienced in difficult intubation)

  • Performing unnecessary medical procedures that result in agitation and respiratory collapse


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