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Epiglottitis

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by

Danielle Aarts

on 17 January 2014

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Transcript of Epiglottitis

Epiglottitis
Risk Factors
Children, age 2-7 years, vaccines not available in some countries.
Signs & Symptoms
The four cardinal signs are dysphonia (difficulty speaking or hoarseness), dysphagia (difficulty swallowing), drooling and distressed respiratory effort with inspiratory stridor.
Medical Interventions
The primary medical intervention related to epiglottitis is making sure the child can breathe.
This is established by:
wearing a mask
intubation
needle trachostomy
The next medical intervention is treating any underlying infection, using either broad spectrum or a more targeted antibiotic.
Oxygen administration is another key intervention for a child with epiglottitis.
Nursing Interventions
Pathophysiology
Causes
Diagnosis
Nursing Process

Goals of Treatment: sufficient breathing pattern; also to get rid of the underlying infection

Interventions: suctioning the airway, positioning the patient in high fowlers, teaching the patient/family about the disease process to decrease anxiety

Evaluation: The patient is able to breathe sufficiently. There are no signs of respiratory distress. The anxiety level of both the patient and family decreases.
Parent Teaching
By: Danielle Aarts, Bryan Avilez, and Alex Owens
Child Teaching
Notify an adult if the child, or anyone around them has difficulty swallowing or breathing
Hand washing to decrease transmission of infectious organisms
Because most children who develop epiglottitis are often very young (<7 years old), teaching is generally directed toward the parents.
Begins with vaccination education before there is any indication that the child may have or develop epiglottitis
Call EMS if any child has problems swallowing or breathing
Do not examine the child's throat, as this may cause further damage
Keep the child upright, so breathing is easier
Preventing further infections
Take all medications as prescribed, until they are finished
Assess the respiratory system for signs of distress such as tachypnea, dyspnea, cyanosis or wheezing.
Have emergency means of intubation ready at the bedside at all times
Monitor continuously to ensure a patent airway.
Administer oxygen, as needed.
Diagnoses: Ineffective airway clearance, decreased tissue perfusion, anxiety
Upper respiratory infection that can be fatal and requires immediate airway management.
Rapid inflammatory edema causes the epiglottis and laryngeal structures to obstuct the airway resulting in hypoxia.
Most commonly occurs in children 2-7 years.
Abrupt onset (minutes to hours), rapidly progresses to respiratory distress, and airway obstruction.
Most commonly caused by H. Influenzae type B.
Immediate identification and intervention are paramount!
Infants younger than 2 years that cannot receive the vaccine.
Higher prevalance of males.
Community quarters, or close quarters.
Day care, and school.
More common in Winter
Higher prevalence of African American and Hispanic.
H. influenzae type b-most common and most deadly.
S. aureus
S. Pneumoniae
Streptococcus A, B, C.
Candida Albicans
V. Zoster
Burns and physical injury to the throat.
Cough
Fever over 103 F
Muffled voice
Tachypnea
Increased breathing difficulty
Leaning forward and arching neck backward to breathe (sniffing postion or tripod position.
Cyanosis of lips and skin
Confusion
Irritability
Sluggishness
Assess respiratory rate, work of breathing, 02 saturation, heart rate, alertness, and color.
Differentiate between upper airway obstruction (inspiratory stridor) and lower respiratory obstruction (cough, wheeze, and prolonged exp. phase).
Throat culture reveals organism and specificity. Do not perform without provider and intubation equipment.
Blood culture
ABG: assess 02 sat and pH imbalance.
Lateral neck X-ray shows an enlarged epiglottis
Throat exam: large, edematous, bright red epiglottis.
Signs and symptoms (cont.)
Lateral Neck X-ray
References
Full transcript