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Epiglottitis, Adult, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Rapidly progressive inflammation of the epiglottis and surrounding tissues leading to airway compromise

  • May be more indolent in adults than pediatrics; rapid progression to total airw...

Diagnosis

Signs and Symptoms

History

  • General:

    • Fever

  • Upper respiratory tract infection symptoms

  • Prodrome absent in significant number of cases

  • Head, eyes, ears, nose, throat:

    • Dysphagia

    • Muffled voice

    • Voice chang...

Treatment

Pre-Hospital

  • Transport patients in position of comfort

  • Supplemental oxygen as tolerated; avoid increasing anxiety

  • Intubation indicated only if patient is in severe respiratory distress:

    • Likely d...

Follow-Up

Disposition

Admission Criteria

Any patient with a suspected or confirmed diagnosis of epiglottitis should be admitted to an ICU setting for IV antibiotics and airway management 

Discharge Criteria

Pearls and Pitfalls

  • Failure to manage the airway in a timely manner

  • Avoid any unnecessary intervention until airway is secured

  • Mortality is 7% in adults with epiglottitis

Additional Reading

  • Guldfred  LA, Lyhne  D, Becker  BC. Acute epiglottitis: Epidemiology, clinical presentation, management and outcome. J Laryngol Otol.  2008;122:818–823.

  • Marx  JA, Hockberger  RS...

Codes

ICD9

  • 464.3 Acute epiglottitis

  • 464.30 Acute epiglottitis without mention of obstruction

  • 464.31 Acute epiglottitis with obstruction

ICD10

  • J05.1 Acute epiglottitis

  • J05.10 Acute epiglottitis without obstr...

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