RESPIRATORY DISTRESS (PED EPIGLOTTITIS)
DESIGNATION OF CONDITION
The most common age group affected is 3 to 7 years, but this process can develop in any age patient. The onset is usually rapid. Signs and symptoms are: Pain on swallowing, high fever (102 to 104) degrees F, drooling, mouth breathing, stridor upon inhalation, changes in voice quality, tripod positioning, chin and neck thrust forward. In addition, other signs of respiratory distress may be present. Since the development of Hemophilus B immunization, the incidence of epiglottitis has been reduced significantly, however it should still be considered for patients presenting with the usual signs and symptoms.
BASIC / AEMT
EMPHASIS ON PATIENT CARE
Prevent agitation to the patient, airway management, and adequate oxygenation
1. Primary Management - Assess ABC’S and manage as indicated.
2. Do not attempt to place anything, including airway adjuncts or fingers, in the patient’s mouth. This may lead to complete airway block or bleeding into airway.
PARAMEDIC
1. Do not attempt to intubate if there is adequate air exchange.
2. Intubation may be very difficult due to swelling of the epiglottis and surrounding structures. Well-performed BVM ventilation can provide adequate oxygenation until arrival at the hospital.
3. Note: Assisted ventilation of any type can agitate the child causing complete airway obstruction. Judicious observation and intervention are best, reserving aggressive airway interventions for children who proceed to respiratory arrest.
4. Note: For pediatric patients, refer to the pediatric-specific treatment guidelines
DESIGNATION OF CONDITION
The most common age group affected is 3 to 7 years, but this process can develop in any age patient. The onset is usually rapid. Signs and symptoms are: Pain on swallowing, high fever (102 to 104) degrees F, drooling, mouth breathing, stridor upon inhalation, changes in voice quality, tripod positioning, chin and neck thrust forward. In addition, other signs of respiratory distress may be present. Since the development of Hemophilus B immunization, the incidence of epiglottitis has been reduced significantly, however it should still be considered for patients presenting with the usual signs and symptoms.
BASIC / AEMT
EMPHASIS ON PATIENT CARE
Prevent agitation to the patient, airway management, and adequate oxygenation
1. Primary Management - Assess ABC’S and manage as indicated.
2. Do not attempt to place anything, including airway adjuncts or fingers, in the patient’s mouth. This may lead to complete airway block or bleeding into airway.
PARAMEDIC
1. Do not attempt to intubate if there is adequate air exchange.
2. Intubation may be very difficult due to swelling of the epiglottis and surrounding structures. Well-performed BVM ventilation can provide adequate oxygenation until arrival at the hospital.
3. Note: Assisted ventilation of any type can agitate the child causing complete airway obstruction. Judicious observation and intervention are best, reserving aggressive airway interventions for children who proceed to respiratory arrest.
4. Note: For pediatric patients, refer to the pediatric-specific treatment guidelines