EPIGLOTTITIS

Prepared by: Katherine Mae V. De Juan, SN

BSN II
Definition:
Epiglottitis is a inflammation of the epiglottis, which is the flap of cartilage that covers the
opening to the larynx to keep out food and fluid during swallowing. Although it is rare,
inflammation of the epiglottis is an emergency because the swollen epiglottis cannot rise and
allow the airway to open. Its a potentially life-threatening illness. The epiglottis is at the base of
the tongue. Its made up of mostly cartilage. Its helps prevent food from entering your windpipe

Organ Affected/Pathophysiology/Cause:

Pathophysiology:
Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae (see Etiology) can colonize
the pharynges of otherwise healthy children through respiratory transmission from intimate
contact. These bacteria may penetrate the mucosal barrier, invading the bloodstream and causing
bacteremia and seeding of the epiglottis and surrounding tissues
Hib infection of the epiglottis leads to acute onset of inflammatory edema, beginning on the
lingual surface of the epiglottis where the submucosa is loosely attached. Swelling significantly
reduces the airway aperture. Edema rapidly progresses to involve the aryepiglottic folds, the
arytenoids, and the entire supraglottic larynx. The tightly bound epithelium on the vocal cords
halts edema spread at this level. Frank airway obstruction, aspiration of oropharyngeal
secretions, or distal mucous plugging can cause respiratory arrest.

Cause:
Most often, Epiglottitis results from infection with Haemophilus influenza type b (Hib)
bacteria. The bacteria spread through the air in tiny droplets when an infected person coughs or
sneezes. The infection starts with a high fever and sore throat. Breathing problems can come on
quickly. Chicken pox can also cause epiglottitis.
Smoking crack cocaine
Burning your throat from drinking hot beverages

Clinical manifestation/S/S:

In children, signs and symptoms of Epiglottitis

may develop within a matter of hours, including:

Fever
Trouble swallowing and talking
Severe Sore Throat
Abnormal, high pitched sound when
breathing, Stridor ( is a late finding)
Difficult and painful Swallowing
Blue skin or lips
Anxious, restlessness behaviour
Craning the neck forward in order to
breathe can be a sign of epiglottitis

Diagnostic Exam:
Initial test
A pulse oximeter is a device that estimates blood oxygen levels.
If oxygen saturation levels drop too low, you or your child may need help breathing.

Tests after stabilizing breathing

Throat examination. Using a flexible fiber-optic-lighted tube, the doctor may look down
your or your child's throat to see what's causing the symptoms. A local anesthetic can
help relieve any discomfort.
Chest or neck X-ray. Because of the danger of sudden breathing problems, children may
have X-rays taken at their bedside rather than in the radiology department but only
after the airway is protected. With epiglottitis, the X-ray may reveal what looks like a
thumbprint in the neck, an indication of an enlarged epiglottis.
Throat culture and blood tests. For the culture, the epiglottis is wiped with a cotton
swab and the tissue sample is checked for Hib.

Treatment/Medication:

The first priority in treating epiglottitis is ensuring that you or

child is receiving enough air.

your

Wearing a mask. The mask delivers oxygen to the

lungs.

Having a breathing tube placed into the windpipe through the nose or mouth
(intubation). The tube must remain in place until the swelling in your or your child's
throat has decreased sometimes for several days.

Inserting a needle into the trachea (needle tracheostomy). In extreme cases or if more
conservative measures fail, the doctor may need to create an emergency airway by
inserting a needle directly into an area of cartilage in your or your child's trachea. This
procedure allows air into your lungs while bypassing the larynx.

Treating infection
If your epiglottitis is related to an infection, intravenous antibiotics will be given once you or
your child is getting enough air.
Broad-spectrum antibiotic. Because of the need for quick
treatment, rather than wait for the results of the blood and
cultures, you or your child is likely to be treated with a
broad-spectrum drug.
More-targeted antibiotic. The drug may be changed later,
depending on what's causing the epiglottitis.
Dont try to examine your childs throat yourself
Dont encourage your child to lie down

Nursing Management:

Wash your hands frequently or use alcohol sanitizer to prevent the spread of germs.
Avoid drinking from the same cup from other people and sharing foods or utensils.
Maintain god immune health with a proper diet.
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