Epiglottitis: NCLEX Priorities
Epiglottitis: tripod, drooling, do NOT examine throat, emergency airway.
Epiglottitis is airway emergency. Cherry-red epiglottis. NCLEX tests recognition and NOT examining the throat.
Recognition
Tripod position, drooling, dysphagia, muffled voice, anxious, toxic-appearing, high fever. Onset rapid (hours). Less common since Hib vaccine.
Critical: do NOT
Do not examine the throat with tongue depressor. Do not draw blood or IV in awake child. Can trigger laryngospasm and complete airway obstruction.
Management
Keep child calm. Position of comfort (often parent's lap). OR for controlled intubation with anesthesia and ENT. Then IV antibiotics (ceftriaxone).
Frequently asked
Common organism?
Historically Hib. Now mostly other Strep species, Staph, less commonly Hib. Cover broadly initially.
Adult epiglottitis?
Real and increasing, fewer vaccinated adults. Same emergency approach.
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