Materiały źródłowe

• #1 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  Epiglottitis is a medical emergency with 2 key treatment goals: airway management and elimination of the infectious pathogen. Airway stabilization must be prioritized before initiating antibiotics, preferably ceftriaxone or an equivalent. Rapid deterioration may occur with little warning, so patients should be treated cautiously to avoid unnecessary sedation, inhalers, racemic epinephrine, or agitation. Oxygen should be offered gently, without force. Common management errors include: […] […] Differentiating epiglottitis and viral laryngotracheobronchitis (croup) may be difficult in pediatric cases. Upper airway obstruction may be due to an acute viral infection, primarily due to parainfluenzavirus 1 or 3. Epiglottitis traditionally has affected children aged between 2 and 7 and may be due to Hib vaccine failure or lack of vaccination. The clinical features of epiglottitis should be distinct from croup and include: […]

• #2 Epiglottitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21236

  Epiglottitis is a medical emergency with 2 key treatment goals: airway management and elimination of the infectious pathogen. Airway stabilization must be prioritized before initiating antibiotics, preferably ceftriaxone or an equivalent. Rapid deterioration may occur with little warning, so patients should be treated cautiously to avoid unnecessary sedation, inhalers, racemic epinephrine, or agitation. Oxygen should be offered gently, without force. Common management errors include: […] […] Differentiating epiglottitis and viral laryngotracheobronchitis (croup) may be difficult in pediatric cases. Upper airway obstruction may be due to an acute viral infection, primarily due to parainfluenzavirus 1 or 3. Epiglottitis traditionally has affected children aged between 2 and 7 and may be due to Hib vaccine failure or lack of vaccination. The clinical features of epiglottitis should be distinct from croup and include: […]

• #3 Epiglottitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/epiglottitis/diagnosis-treatment/drc-20372231

  Helping a person breathe is the first step in treating epiglottitis. Then treatment focuses on the infection. […] Making sure that you or your child is breathing well might mean: […] Wearing an oxygen mask. The mask sends oxygen to the lungs. […] Having a breathing tube placed into the windpipe through the nose or mouth, known as intubation. The tube stays in place until the swelling in the throat goes down. This can take many days. […] Putting a needle into the windpipe, known as a needle cricothyroidotomy. In rare cases, a health care provider creates an emergency airway. To get air into the lungs quickly, a provider puts a needle into an area of cartilage in the windpipe, also known as the trachea. […] Antibiotics given through a vein treat epiglottitis. […] The infection needs quick treatment. So, a health care provider might prescribe a broad-spectrum drug right away, rather than waiting for results of the blood and tissue cultures. […] The first medicine may be changed later, depending on what’s causing the epiglottitis.

• #4 Epiglottitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17844-epiglottitis

  Youll receive treatment for epiglottitis immediately. In the hospital, your care team will: […] Restore your airways to full capacity. Your healthcare provider will place an oxygen mask over your mouth and nose so your lungs can get more air. If your air passages are blocked, they may place a breathing tube through your mouth and into your windpipe. (If your provider cant insert a breathing tube through your mouth, they may need to insert a breathing tube through your neck. This is called a tracheostomy. But its rare that people with epiglottitis need this.) […] Administer antibiotics. If you have a bacterial infection, your provider will give you a broad-spectrum antibiotic through an IV. This medicine kills most strains of bacteria that may be causing the infection. Once your provider gets the results of your culture tests, they may give you a different antibiotic that targets the specific bacteria causing your infection. […] When addressed quickly, treatment can heal epiglottitis. Still, its important to remember that an inflamed epiglottis is a medical emergency. If you or someone you know exhibits epiglottitis symptoms, call 911 (or your local emergency services number) or head to your nearest emergency room.

• #5 Epiglottitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/epiglottitis

  A hospital stay is needed, usually in the intensive care unit (ICU). […] Treatment involves methods to help the person breathe, including: […] Breathing tube (intubation) […] Moistened (humidified) oxygen […] A surgical airway, called tracheostomy, as a last resort if other measures fail […] Other treatments may include: […] Antibiotics to treat the infection […] Anti-inflammatory medicines, called corticosteroids, to decrease throat swelling […] Fluids given through a vein (by IV).

• #6 Epiglottitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17844-epiglottitis

  Youll receive treatment for epiglottitis immediately. In the hospital, your care team will: […] Restore your airways to full capacity. Your healthcare provider will place an oxygen mask over your mouth and nose so your lungs can get more air. If your air passages are blocked, they may place a breathing tube through your mouth and into your windpipe. (If your provider cant insert a breathing tube through your mouth, they may need to insert a breathing tube through your neck. This is called a tracheostomy. But its rare that people with epiglottitis need this.) […] Administer antibiotics. If you have a bacterial infection, your provider will give you a broad-spectrum antibiotic through an IV. This medicine kills most strains of bacteria that may be causing the infection. Once your provider gets the results of your culture tests, they may give you a different antibiotic that targets the specific bacteria causing your infection. […] When addressed quickly, treatment can heal epiglottitis. Still, its important to remember that an inflamed epiglottis is a medical emergency. If you or someone you know exhibits epiglottitis symptoms, call 911 (or your local emergency services number) or head to your nearest emergency room.

• #7 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Avoid agitating the patient with acute epiglottitis. Let the patient take a position in which he or she feels comfortable. […] Orotracheal intubation may be required with little warning. Equipment for intubation, cricothyroidotomy, or needle-jet ventilation should be made available at the bedside. […] Avoid therapy such as sedation, inhalers, or racemic epinephrine. […] Administer supplemental humidified oxygen if possible, but do not force the patient, as the resultant agitation could worsen the condition. […] In a retrospective study of 216 adult cases of acute epiglottitis, Nonoyama et al found that most cases received conservative treatment, with just 39 patients (18.1%) requiring airway management. […] A systematic review and meta-analysis by Sideris et al suggested that airway securement is required in 10.9% of adult cases (down from 18.8% prior to the introduction of Haemophilus influenzae vaccine).

• #8 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  Supplemental blow-by oxygen should be administered while preparing for emergent airway management, which often includes controlled intubation or, in severe cases, needle cricothyroidotomy or tracheostomy. Ideally, emergency airway intervention should occur in the operating room to visualize the airway first with a laryngoscope. If endotracheal intubation is not feasible, a tracheostomy should be performed. After securing the airway, empiric antibiotics, such as cefuroxime, ceftriaxone, or cefotaxime, should be administered to cover common respiratory and oral pathogens. Due to heightened clinical awareness and improved protocols, pediatric death rates following intubation or airway control have dropped to less than 1%, though delays in transport or diagnosis still contribute to fatalities. […]

• #9 Epiglottitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/epiglottitis/diagnosis-treatment/drc-20372231

  Helping a person breathe is the first step in treating epiglottitis. Then treatment focuses on the infection. […] Making sure that you or your child is breathing well might mean: […] Wearing an oxygen mask. The mask sends oxygen to the lungs. […] Having a breathing tube placed into the windpipe through the nose or mouth, known as intubation. The tube stays in place until the swelling in the throat goes down. This can take many days. […] Putting a needle into the windpipe, known as a needle cricothyroidotomy. In rare cases, a health care provider creates an emergency airway. To get air into the lungs quickly, a provider puts a needle into an area of cartilage in the windpipe, also known as the trachea. […] Antibiotics given through a vein treat epiglottitis. […] The infection needs quick treatment. So, a health care provider might prescribe a broad-spectrum drug right away, rather than waiting for results of the blood and tissue cultures. […] The first medicine may be changed later, depending on what’s causing the epiglottitis.

• #10 Epiglottitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/epiglottitis/diagnosis-treatment/drc-20372231

  Helping a person breathe is the first step in treating epiglottitis. Then treatment focuses on the infection. […] Making sure that you or your child is breathing well might mean: […] Wearing an oxygen mask. The mask sends oxygen to the lungs. […] Having a breathing tube placed into the windpipe through the nose or mouth, known as intubation. The tube stays in place until the swelling in the throat goes down. This can take many days. […] Putting a needle into the windpipe, known as a needle cricothyroidotomy. In rare cases, a health care provider creates an emergency airway. To get air into the lungs quickly, a provider puts a needle into an area of cartilage in the windpipe, also known as the trachea. […] Antibiotics given through a vein treat epiglottitis. […] The infection needs quick treatment. So, a health care provider might prescribe a broad-spectrum drug right away, rather than waiting for results of the blood and tissue cultures. […] The first medicine may be changed later, depending on what’s causing the epiglottitis.

• #11 Epiglottitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17844-epiglottitis

  Youll receive treatment for epiglottitis immediately. In the hospital, your care team will: […] Restore your airways to full capacity. Your healthcare provider will place an oxygen mask over your mouth and nose so your lungs can get more air. If your air passages are blocked, they may place a breathing tube through your mouth and into your windpipe. (If your provider cant insert a breathing tube through your mouth, they may need to insert a breathing tube through your neck. This is called a tracheostomy. But its rare that people with epiglottitis need this.) […] Administer antibiotics. If you have a bacterial infection, your provider will give you a broad-spectrum antibiotic through an IV. This medicine kills most strains of bacteria that may be causing the infection. Once your provider gets the results of your culture tests, they may give you a different antibiotic that targets the specific bacteria causing your infection. […] When addressed quickly, treatment can heal epiglottitis. Still, its important to remember that an inflamed epiglottis is a medical emergency. If you or someone you know exhibits epiglottitis symptoms, call 911 (or your local emergency services number) or head to your nearest emergency room.

• #12 Epiglottitis Medication: Antibiotics, Analgesic-antipyretics

  https://emedicine.medscape.com/article/763612-medication

  Antibiotic therapy should begin after blood and epiglottic cultures have been obtained. Antipyretic agents may also be necessary. Racemic epinephrine, corticosteroids, and beta-agonists have not been proven to be helpful in epiglottitis. In addition, corticosteroid usage remains controversial, as anecdotal reports in the past had supported its use. […] A study by Lee et al indicated that the treatment of epiglottic abscess with a combination of needle aspiration and antibiotics can reduce hospitalization time for patients below that for patients treated with antibiotics alone. However, the study also found that outcomes of the two treatments did not significantly differ, with significant symptom improvement achieved in both groups. […] Empiric coverage for Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae should be provided (a third-generation cephalosporin or amoxicillin/clavulanic acid) in the management of epiglottitis. Third-generation cephalosporins are preferred as first-line agents because of increasing resistance to ampicillin.

• #13 Epiglottitis Medication: Antibiotics, Analgesic-antipyretics

  https://emedicine.medscape.com/article/763612-medication

  Ceftriaxone is the antibiotic of choice (DOC) for epiglottitis. This agent is a third-generation cephalosporin with broad-spectrum activity against gram-negative organisms, lower efficacy against gram-positive organisms, and higher efficacy against resistant organisms. […] Ampicillin with sulbactam is used as an alternative to amoxicillin when the patient is unable to take medication orally. This combination covers skin, enteric flora, and anaerobes but is not ideal for nosocomial pathogens. […] Chloramphenicol is used if patients are allergic to penicillin and cephalosporins. This agent binds to the 50S bacterial-ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis. Chloramphenicol is effective against gram-negative and gram-positive bacteria. […] Analgesic-antipyretic agents are helpful in relieving the lethargy, malaise, and fever associated with epiglottitis.

• #14 EM@3AM: Epiglottitis – emDocs

  https://www.emdocs.net/em3am-epiglottitis-2/

  – Antibiotics: Ceftriaxone 2g intravenous (IV) or ampicillin-sulbactam 3g IV with vancomycin 20 mg/kg IV for methicillin resistant Staphylococcus aureus (MRSA) coverage […] – Severe penicillin allergy: levofloxacin 750 mg IV […] – Immunocompromised: cefepime 2g IV is recommended for P. aeruginosa coverage […] […] […] – Corticosteroids are controversial though between 20-83% will receive corticosteroids […] – Have not demonstrated any improvement in ICU length of stay, hospital length of stay, or duration of intubation […] […] […] – Nebulized epinephrine may help temporize airway by assisting with bronchodilation […] – Do not use in children […] – Generates additional agitation, laryngospasm and rapid deterioration though no benefit

• #15 Epiglottitis Medication: Antibiotics, Analgesic-antipyretics

  https://emedicine.medscape.com/article/763612-medication

  Ceftriaxone is the antibiotic of choice (DOC) for epiglottitis. This agent is a third-generation cephalosporin with broad-spectrum activity against gram-negative organisms, lower efficacy against gram-positive organisms, and higher efficacy against resistant organisms. […] Ampicillin with sulbactam is used as an alternative to amoxicillin when the patient is unable to take medication orally. This combination covers skin, enteric flora, and anaerobes but is not ideal for nosocomial pathogens. […] Chloramphenicol is used if patients are allergic to penicillin and cephalosporins. This agent binds to the 50S bacterial-ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis. Chloramphenicol is effective against gram-negative and gram-positive bacteria. […] Analgesic-antipyretic agents are helpful in relieving the lethargy, malaise, and fever associated with epiglottitis.

• #16 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Treatment-of-epiglottitis.aspx

  Treatment of epiglottitis includes endotracheal intubation, antibiotic therapy and so forth. […] Patients are shifted to the intensive care unit (ICU) under closed monitoring and if not attempted previously they should undergo endotracheal intubation. […] Antibiotic therapy is begun as soon as diagnosis is made. Specific antibiotics that are effective against the causative organism may be started after the results of epiglottic cultures are obtained and the infective organism identified. […] Usually therapy is begun with antibiotics like ampicillin/sulbactam, amoxicillin/clavulanic acid or cephalosporin group of drugs like ceftriaxone (given intravenously), cefuroxime (can be given both intravenously and orally) and cefotaxime (given intravenously). […] Chloramphenicol is another alternative antibiotic that can be given in patients who are allergic to penicillin. Most people will need to take a seven- to ten-day course of antibiotics. […] Antibiotics may be started intravenously and with adequate initial response to the infection they may be switched over to oral antibiotic pills as appropriate.

• #17 EM@3AM: Epiglottitis – emDocs

  https://www.emdocs.net/em3am-epiglottitis-2/

  – Antibiotics: Ceftriaxone 2g intravenous (IV) or ampicillin-sulbactam 3g IV with vancomycin 20 mg/kg IV for methicillin resistant Staphylococcus aureus (MRSA) coverage […] – Severe penicillin allergy: levofloxacin 750 mg IV […] – Immunocompromised: cefepime 2g IV is recommended for P. aeruginosa coverage […] […] […] – Corticosteroids are controversial though between 20-83% will receive corticosteroids […] – Have not demonstrated any improvement in ICU length of stay, hospital length of stay, or duration of intubation […] […] […] – Nebulized epinephrine may help temporize airway by assisting with bronchodilation […] – Do not use in children […] – Generates additional agitation, laryngospasm and rapid deterioration though no benefit

• #18 Epiglottitis medical therapy – wikidoc

  https://www.wikidoc.org/index.php/Epiglottitis_medical_therapy

  In view of the emergence of Streptococcus pneumoniae, beta-hemolytic streptococci, and ampicillin-resistant Haemophilus influenzae as the most common causative bacteria of acute epiglottitis, empiric therapy with a third-generation cephalosporin (such as cefotaxime and ceftriaxone) or ampicillin-sulbactam is recommended. […] An anti-staphylococcal agent (such as vancomycin or clindamycin) should be added to the initial treatment in areas with increased prevalence of methicillin-resistant Staphylococcus aureus (MRSA) or penicillin-resistant pneumococci. […] The optimal duration of antimicrobial therapy is yet to be determined. Acute epiglottitis usually responds to a 7 to 10 day course of intravenous antibiotics. […] Although adjuvant corticosteroids and racemic epinephrine are commonly used in the management of stridor associated with acute epiglottitis, neither of them were proved effective in reducing the need of airway intervention or shortening the hospitalization.

• #19 EM@3AM: Epiglottitis – emDocs

  https://www.emdocs.net/em3am-epiglottitis-2/

  – Antibiotics: Ceftriaxone 2g intravenous (IV) or ampicillin-sulbactam 3g IV with vancomycin 20 mg/kg IV for methicillin resistant Staphylococcus aureus (MRSA) coverage […] – Severe penicillin allergy: levofloxacin 750 mg IV […] – Immunocompromised: cefepime 2g IV is recommended for P. aeruginosa coverage […] […] […] – Corticosteroids are controversial though between 20-83% will receive corticosteroids […] – Have not demonstrated any improvement in ICU length of stay, hospital length of stay, or duration of intubation […] […] […] – Nebulized epinephrine may help temporize airway by assisting with bronchodilation […] – Do not use in children […] – Generates additional agitation, laryngospasm and rapid deterioration though no benefit

• #20 Epiglottitis medical therapy – wikidoc

  https://www.wikidoc.org/index.php/Epiglottitis_medical_therapy

  In view of the emergence of Streptococcus pneumoniae, beta-hemolytic streptococci, and ampicillin-resistant Haemophilus influenzae as the most common causative bacteria of acute epiglottitis, empiric therapy with a third-generation cephalosporin (such as cefotaxime and ceftriaxone) or ampicillin-sulbactam is recommended. […] An anti-staphylococcal agent (such as vancomycin or clindamycin) should be added to the initial treatment in areas with increased prevalence of methicillin-resistant Staphylococcus aureus (MRSA) or penicillin-resistant pneumococci. […] The optimal duration of antimicrobial therapy is yet to be determined. Acute epiglottitis usually responds to a 7 to 10 day course of intravenous antibiotics. […] Although adjuvant corticosteroids and racemic epinephrine are commonly used in the management of stridor associated with acute epiglottitis, neither of them were proved effective in reducing the need of airway intervention or shortening the hospitalization.

• #21 Epiglottitis: Causes, Symptoms, Diagnosis and Treatment

  https://www.webmd.com/a-to-z-guides/epiglottitis-infection-inflammation

  IV fluids. Until you’re able to swallow normally, you’ll get fluid through your IV. […] Corticosteroids. These can be used to bring down swelling. […] Take all antibiotics and any other medication you may be prescribed exactly as your doctor tells you to. Keep all follow-up appointments with the doctor and with the surgeon if a breathing tube was placed through your neck. The surgeon will remove the tube and make sure the site is healing well. Call your doctor right away or go back to the hospital if you have any problems.

• #22 Epiglottitis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/epiglottitis

  The treatment for epiglottitis requires immediate emergency care to prevent complete airway occlusion. The child’s airway will be closely monitored, and, if needed, the child’s breathing will be assisted with machines. […] Also, intravenous (IV) therapy with antibiotics will be started immediately. This will help treat the infection by the bacteria. Treatment may also include: […] Steroid medication (to reduce airway swelling) […] Intravenous (IV) fluids, until the child can swallow again […] Humidified oxygen […] Breathing tube.

• #23 Epiglottitis: Causes, Symptoms, Diagnosis and Treatment

  https://www.webmd.com/a-to-z-guides/epiglottitis-infection-inflammation

  IV fluids. Until you’re able to swallow normally, you’ll get fluid through your IV. […] Corticosteroids. These can be used to bring down swelling. […] Take all antibiotics and any other medication you may be prescribed exactly as your doctor tells you to. Keep all follow-up appointments with the doctor and with the surgeon if a breathing tube was placed through your neck. The surgeon will remove the tube and make sure the site is healing well. Call your doctor right away or go back to the hospital if you have any problems.

• #24 Epiglottitis – EMCrit Project

  https://emcrit.org/ibcc/epiglottitis/

  Medical Management: [1/3] antibiotics […] Preferred antibiotics: Third-generation cephalosporin is generally the front-line choice (e.g., ceftriaxone 2 gram IV Q24hr for seven days). […] [2/3] steroid: Intermediate dose steroid is generally used (e.g., 125 mg methylprednisolone IV once, then lower doses daily for a few days). […] [3/3] nebulized (racemic) epinephrine: Racemic epinephrine might be a reasonable consideration to temporize edema, allowing time for steroid and antibiotic to take effect. […] management implications: There is no definitive evidence regarding how to manage epiglottic abscess. […] Bottom line? Don’t assume that an abscess necessarily mandates drainage or intubation (many patients may respond to medical therapy alone). […] Most patients won’t require intubation. When in doubt, watchful waiting is generally best, as patients will tend to improve with medical therapy. […] DO NOT USE RAPID SEQUENCE INTUBATION IN AN EPIGLOTTITIS PATIENT.

• #25 Epiglottitis Medication: Antibiotics, Analgesic-antipyretics

  https://emedicine.medscape.com/article/763612-medication

  Acetaminophen is the drug of choice (DOC) for treating pain in patients with documented hypersensitivity to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), those with upper gastrointestinal disease, or those who take oral anticoagulants. This agent reduces fever by a direct action on the hypothalamic heat-regulating centers, which increases dissipation of body heat via vasodilation and sweating. […] Ibuprofen is usually the drug of choice (DOC) for treating mild to moderate pain, if no contraindications exist. This agent inhibits inflammatory reactions and pain, probably by decreasing the activity of the cyclooxygenase enzyme, which inhibits prostaglandin synthesis. Ibuprofen is one of the few nonsteroidal anti-inflammatory drugs (NSAIDs) that is indicated for reduction of fever.

• #26 Epiglottitis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/epiglottitis

  The treatment for epiglottitis requires immediate emergency care to prevent complete airway occlusion. The child’s airway will be closely monitored, and, if needed, the child’s breathing will be assisted with machines. […] Also, intravenous (IV) therapy with antibiotics will be started immediately. This will help treat the infection by the bacteria. Treatment may also include: […] Steroid medication (to reduce airway swelling) […] Intravenous (IV) fluids, until the child can swallow again […] Humidified oxygen […] Breathing tube.

• #27 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #28 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #29 CoxHealth | Epiglottitis in Children

  https://www.coxhealth.com/condition/epiglottitis-in-children/

  The treatment for epiglottitis calls for emergency care right away to stop the airway from being blocked. The medical staff will put in a breathing tube right away. They’ll closely watch your child’s airway. Your child may need a machine (ventilator) to help them breathe. […] Treatment may also include: IV (intravenous) therapy with antibiotics if the cause is a bacterial infection […] Steroid medicine to ease airway swelling […] IV fluids until the child can swallow again. […] How well your child recovers is related to how quickly treatment begins in the hospital. Once your child’s airway is safe and antibiotics are started, epiglottitis often stops getting worse within 24 hours. A full recovery takes longer and depends on your child’s condition.

• #30 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #31 Croup vs Epiglottitis: Quick EMS Guide

  https://medictests.com/units/the-quick-and-dirty-guide-to-croup-and-epiglottitis

  Epiglottitis Treatment […] Children with acute epiglottitis are in danger of full airway obstruction and respiratory arrest that comes on rapidly and may be caused by minor irritation of the throat. For this reason; gentle handling of a child suspected of having epiglottitis is essential. The following guidelines should be observed when dealing with the potentially fatal illness: […] DO NOT try to lay the patient flat or dictate their position of comfort […] DO NOT visualize the airway if the airway of the child is still adequately ventilating […] Advise the receiving facility of your suspicion of epiglottitis […] Administer 100% humidified oxygen by mask, if tolerated […] DO NOT attempt vascular access (the added stress can be detrimental to the airway) […] Have the proper advanced airway adjuncts ready and at hand

• #32 CoxHealth | Epiglottitis in Children

  https://www.coxhealth.com/condition/epiglottitis-in-children/

  The treatment for epiglottitis calls for emergency care right away to stop the airway from being blocked. The medical staff will put in a breathing tube right away. They’ll closely watch your child’s airway. Your child may need a machine (ventilator) to help them breathe. […] Treatment may also include: IV (intravenous) therapy with antibiotics if the cause is a bacterial infection […] Steroid medicine to ease airway swelling […] IV fluids until the child can swallow again. […] How well your child recovers is related to how quickly treatment begins in the hospital. Once your child’s airway is safe and antibiotics are started, epiglottitis often stops getting worse within 24 hours. A full recovery takes longer and depends on your child’s condition.

• #33 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #34 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #35 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Patients without signs of airway compromise, respiratory difficulty, stridor, or drooling, and who have only mild swelling on laryngoscopy, may be managed without immediate airway intervention by close monitoring in the intensive care unit (ICU). […] Close contacts of patients in whom Haemophilus influenzae type b is isolated should receive rifampin prophylaxis (20 mg/kg; not to exceed 600 mg/d for 4 d). […] Occurrence of recurrent episodes of acute epiglottitis in adults is unusual and, when present, warrants immune system investigation, because a quantitative or specific antibiotic deficiency may be present. Treatment of patients with recurrent acute epiglottitis may involve immunization or antibody replacement. […] An anesthesiologist and an ear, nose, and throat (ENT) specialist or a general surgeon should be notified as soon as possible when epiglottitis is suspected. Early anesthesiologist and otolaryngologist consultation facilitates initial safe airway management, which is then followed by appropriate antibiotic treatment.

• #36 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #37 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  Otolaryngologic evaluation in adults is crucial to assess airway status and predict the risk of rapid progression. Many otolaryngologists recommend intensive care observation, antibiotics, and steroids for mild-to-moderate swelling in adults without high-risk factors like diabetes or epiglottic abscess. Inhalation induction, common in pediatric cases, has an unclear role in adults, and a backup tracheostomy plan should always be in place. […] […] Adult mortality from epiglottitis can reach 7% to 10%, which is much higher than in children. Neuromuscular blocking agent use remains controversial, as reduced airway tone may cause complete obstruction. Airway management failures in adults often result from: […] […] No consensus exists on the optimal management of adult epiglottitis due to varying clinical presentations, healthcare settings, expertise, and resources. Pediatric epiglottitis may be more straightforward to manage than adult cases, but successful treatment across all ages requires rapid, accurate diagnosis, proper identification of patients needing immediate airway control, anticipation of deterioration, and preparedness for front-of-neck airway access. While no definitive guide for airway management in this life-threatening condition exists, prompt and skilled intervention is essential to prevent fatal outcomes.

• #38 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Obstruction in acute epiglottitis can be reduced by using dexamethasone therapy or budesonide aerosols to treat pharyngeal edema. In addition, research suggests that length of stay in the intensive care unit (ICU) and in the hospital overall can be reduced with corticosteroid use. […] Do not attempt intubation in the field unless acute airway obstruction is present. In the event of respiratory failure or obstruction, if emergency medical services (EMS) is unable to intubate, then cricothyroidotomy or needle-jet insufflation are the next lines of treatment. […] A patient in extremis requires immediate airway management. Signs and symptoms associated with a need for intubation include respiratory distress, airway compromise on examination, stridor, inability to swallow, drooling, sitting erect, and deterioration within 8-12 hours.

• #39 EM@3AM: Epiglottitis – emDocs

  https://www.emdocs.net/em3am-epiglottitis-2/

  Treatment […] – Position of optimal patient comfort is key […] – Airway management […] – Intubation with flexible intubating endoscopy is the method of choice […] – Intubation occurs in epiglottitis patients in 13.2% of cases […] – Video laryngoscopy is used less commonly but is also an option […] – Do not use supraglottic devices; may not seat well and may cause airway occlusion […] – Factors associated with increased likelihood of intubation: Historical factors: Diabetes mellitus, subjective dyspnea, rapid symptom progression over 12-24 hours, stridor, Objective measures: 20 breaths per minute with subjective complaint of dyspnea required visualization of the airway, while a respiratory rate greater than 30 breaths per minute, hypercarbia (PCO2 greater than 45 mm Hg) […] […]

• #40 EM@3AM: Epiglottitis – emDocs

  https://www.emdocs.net/em3am-epiglottitis-2/

  Treatment […] – Position of optimal patient comfort is key […] – Airway management […] – Intubation with flexible intubating endoscopy is the method of choice […] – Intubation occurs in epiglottitis patients in 13.2% of cases […] – Video laryngoscopy is used less commonly but is also an option […] – Do not use supraglottic devices; may not seat well and may cause airway occlusion […] – Factors associated with increased likelihood of intubation: Historical factors: Diabetes mellitus, subjective dyspnea, rapid symptom progression over 12-24 hours, stridor, Objective measures: 20 breaths per minute with subjective complaint of dyspnea required visualization of the airway, while a respiratory rate greater than 30 breaths per minute, hypercarbia (PCO2 greater than 45 mm Hg) […] […]

• #41

  https://journals.lww.com/jcsr/fulltext/2020/09020/acute_epiglottitis___a_life_threatening_clinical.8.aspx

  According to the treatment protocol of AE, the glottic and supraglottic airway should be assessed by an otolaryngologist by a fibreoptic laryngoscopy and found whether the airway is patent or compromised. […] The key to the treatment of AE is awareness of the disease and close monitoring of the airway. […] In case of 50% narrowing of the airway, tracheal intubation may be done depending on the severity of the patient’s condition. […] Management of the airway in patients of AE is very crucial, particularly in severe cases of AE, but the airway procedure is needed in cases of 10% of the patients. […] The presence of clinical findings, such as, stridor, tachypnoea, hypoxia and drooling of the saliva at the time of diagnosis of AE indicate the requirement of an airway procedure.

• #42 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Avoid agitating the patient with acute epiglottitis. Let the patient take a position in which he or she feels comfortable. […] Orotracheal intubation may be required with little warning. Equipment for intubation, cricothyroidotomy, or needle-jet ventilation should be made available at the bedside. […] Avoid therapy such as sedation, inhalers, or racemic epinephrine. […] Administer supplemental humidified oxygen if possible, but do not force the patient, as the resultant agitation could worsen the condition. […] In a retrospective study of 216 adult cases of acute epiglottitis, Nonoyama et al found that most cases received conservative treatment, with just 39 patients (18.1%) requiring airway management. […] A systematic review and meta-analysis by Sideris et al suggested that airway securement is required in 10.9% of adult cases (down from 18.8% prior to the introduction of Haemophilus influenzae vaccine).

• #43 Epiglottitis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/epiglottitis

  If your doctor thinks you have epiglottitis, the first treatments typically involve monitoring your oxygen levels with a pulse oximetry device and protecting your airway. If your blood oxygen levels become too low, you’ll likely get supplemental oxygen through a breathing tube or mask. […] Your doctor may also give you one or all of the following treatments: intravenous fluids for nutrition and hydration until you’re able to swallow again, antibiotics to treat a known or suspected bacterial infection, anti-inflammatory medication, such as corticosteroids, to reduce the swelling in your throat. […] In severe cases, you may need a tracheostomy or cricothyroidotomy. […] A tracheostomy is a minor surgical procedure where a small incision is made between the tracheal rings. Then a breathing tube is placed directly through your neck and into your windpipe, bypassing your epiglottis. This allows exchange of oxygen and prevents respiratory failure. […] If you seek immediate medical attention, you can expect a full recovery in most cases.

• #44 Epiglottitis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/epiglottitis

  Epiglottitis requires immediate emergency care to prevent your child from stopping breathing. Once your child is being monitored, the airway is safe and antibiotics are started, the disease usually stops progressing within 24 hours. Complete recovery takes longer and depends on each child’s condition. […] Treatment may include: […] Intravenous (IV) therapy with antibiotics to treat the infection […] Steroid medication (to reduce airway swelling) […] If your child is diagnosed with epiglottitis, your family or other close contacts are usually treated with a medication called Rifampin, to prevent the disease in those people who might have been exposed.

• #45 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Avoid agitating the patient with acute epiglottitis. Let the patient take a position in which he or she feels comfortable. […] Orotracheal intubation may be required with little warning. Equipment for intubation, cricothyroidotomy, or needle-jet ventilation should be made available at the bedside. […] Avoid therapy such as sedation, inhalers, or racemic epinephrine. […] Administer supplemental humidified oxygen if possible, but do not force the patient, as the resultant agitation could worsen the condition. […] In a retrospective study of 216 adult cases of acute epiglottitis, Nonoyama et al found that most cases received conservative treatment, with just 39 patients (18.1%) requiring airway management. […] A systematic review and meta-analysis by Sideris et al suggested that airway securement is required in 10.9% of adult cases (down from 18.8% prior to the introduction of Haemophilus influenzae vaccine).

• #46

  https://journals.lww.com/jcsr/fulltext/2020/09020/acute_epiglottitis___a_life_threatening_clinical.8.aspx

  According to the treatment protocol of AE, the glottic and supraglottic airway should be assessed by an otolaryngologist by a fibreoptic laryngoscopy and found whether the airway is patent or compromised. […] The key to the treatment of AE is awareness of the disease and close monitoring of the airway. […] In case of 50% narrowing of the airway, tracheal intubation may be done depending on the severity of the patient’s condition. […] Management of the airway in patients of AE is very crucial, particularly in severe cases of AE, but the airway procedure is needed in cases of 10% of the patients. […] The presence of clinical findings, such as, stridor, tachypnoea, hypoxia and drooling of the saliva at the time of diagnosis of AE indicate the requirement of an airway procedure.

• #47 Epiglottitis Medication: Antibiotics, Analgesic-antipyretics

  https://emedicine.medscape.com/article/763612-medication

  Antibiotic therapy should begin after blood and epiglottic cultures have been obtained. Antipyretic agents may also be necessary. Racemic epinephrine, corticosteroids, and beta-agonists have not been proven to be helpful in epiglottitis. In addition, corticosteroid usage remains controversial, as anecdotal reports in the past had supported its use. […] A study by Lee et al indicated that the treatment of epiglottic abscess with a combination of needle aspiration and antibiotics can reduce hospitalization time for patients below that for patients treated with antibiotics alone. However, the study also found that outcomes of the two treatments did not significantly differ, with significant symptom improvement achieved in both groups. […] Empiric coverage for Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae should be provided (a third-generation cephalosporin or amoxicillin/clavulanic acid) in the management of epiglottitis. Third-generation cephalosporins are preferred as first-line agents because of increasing resistance to ampicillin.

• #48 Epiglottitis: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/epiglottitis-pro

  Initial presentation may resemble a viral sore throat, so a high index of suspicion is needed. Emergency referral is required if signs of airway obstruction are present (stridor). Deterioration in symptoms may be rapid, especially in children. […] Management is usually conservative with intravenous or oral antibiotics but intubation may be needed. […] Surgical tracheostomy may be required in patients with severe airway obstruction in whom intubation has not been possible. […] Abscess formation is increasing in incidence. This may partly be explained by advances in imaging (CT and MRI). Drainage may be required in some patients.

• #49 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #50

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2916

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have worsening symptoms of infection, such as: Increased pain, swelling, warmth, or redness. Pus draining from the area. A fever. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You do not get better as expected.

• #51 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #52 Epiglottitis: Causes, Symptoms, Diagnosis and Treatment

  https://www.webmd.com/a-to-z-guides/epiglottitis-infection-inflammation

  IV fluids. Until you’re able to swallow normally, you’ll get fluid through your IV. […] Corticosteroids. These can be used to bring down swelling. […] Take all antibiotics and any other medication you may be prescribed exactly as your doctor tells you to. Keep all follow-up appointments with the doctor and with the surgeon if a breathing tube was placed through your neck. The surgeon will remove the tube and make sure the site is healing well. Call your doctor right away or go back to the hospital if you have any problems.

• #53 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  After securing the airway, patients should be admitted to the intensive care unit, and culture swabs should be obtained post-intubation. Corticosteroids may reduce edema, shortening intensive care requirements. Antibiotic regimens should be adjusted based on culture and sensitivity results. Extubation can be considered once a leak is demonstrated around the deflated endotracheal tube cuff. […] […] All non-intubated patients require admission to the intensive care unit with a tracheostomy tray readily available. Otolaryngologists and anesthesiologists must be alerted in case of an emergency airway situation. Nurses should avoid placing the child supine and minimize unnecessary movements or interventions. […] […] Managing epiglottitis in adults differs significantly from children, as adults often present with inflammation throughout the supraglottis. Advances in monitoring, technology, and fiberoptic laryngoscopy training have reduced the need for urgent intubation or tracheostomy. Unlike children, adults may tolerate physical examinations, imaging, or more conservative measures without immediate airway compromise. Awake fiberoptic intubation, when performed under proper conditions, has a high success rate in less severe cases but should only be attempted with a cooperative patient by trained otolaryngology and anesthesiology specialists and never in extreme cases where immediate laryngoscopy or tracheostomy may be the only option. […]

• #54 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Patients without signs of airway compromise, respiratory difficulty, stridor, or drooling, and who have only mild swelling on laryngoscopy, may be managed without immediate airway intervention by close monitoring in the intensive care unit (ICU). […] Close contacts of patients in whom Haemophilus influenzae type b is isolated should receive rifampin prophylaxis (20 mg/kg; not to exceed 600 mg/d for 4 d). […] Occurrence of recurrent episodes of acute epiglottitis in adults is unusual and, when present, warrants immune system investigation, because a quantitative or specific antibiotic deficiency may be present. Treatment of patients with recurrent acute epiglottitis may involve immunization or antibody replacement. […] An anesthesiologist and an ear, nose, and throat (ENT) specialist or a general surgeon should be notified as soon as possible when epiglottitis is suspected. Early anesthesiologist and otolaryngologist consultation facilitates initial safe airway management, which is then followed by appropriate antibiotic treatment.

• #55 Epiglottitis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/epiglottitis

  Epiglottitis requires immediate emergency care to prevent your child from stopping breathing. Once your child is being monitored, the airway is safe and antibiotics are started, the disease usually stops progressing within 24 hours. Complete recovery takes longer and depends on each child’s condition. […] Treatment may include: […] Intravenous (IV) therapy with antibiotics to treat the infection […] Steroid medication (to reduce airway swelling) […] If your child is diagnosed with epiglottitis, your family or other close contacts are usually treated with a medication called Rifampin, to prevent the disease in those people who might have been exposed.

• #56 Epiglottitis – Wikipedia

  https://en.wikipedia.org/wiki/Epiglottitis

  An effective vaccine, the Hib vaccine, has been available since the 1980s. […] The most important part of treatment involves securing the airway, which is often done by endotracheal intubation. […] Intravenous antibiotics such as ceftriaxone and possibly vancomycin or clindamycin is then given. […] Corticosteroids are also typically used. […] Epiglottitis may require urgent tracheal intubation to protect the airway. […] Intravenous antibiotics such as ceftriaxone and possibly vancomycin or clindamycin are given once the airway is secure. […] Necrotizing epiglottitis is treated similarly to uncomplicated epiglottitis, but usually requires intubation in addition to standard IV antibiotic therapy.

• #57 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Patients without signs of airway compromise, respiratory difficulty, stridor, or drooling, and who have only mild swelling on laryngoscopy, may be managed without immediate airway intervention by close monitoring in the intensive care unit (ICU). […] Close contacts of patients in whom Haemophilus influenzae type b is isolated should receive rifampin prophylaxis (20 mg/kg; not to exceed 600 mg/d for 4 d). […] Occurrence of recurrent episodes of acute epiglottitis in adults is unusual and, when present, warrants immune system investigation, because a quantitative or specific antibiotic deficiency may be present. Treatment of patients with recurrent acute epiglottitis may involve immunization or antibody replacement. […] An anesthesiologist and an ear, nose, and throat (ENT) specialist or a general surgeon should be notified as soon as possible when epiglottitis is suspected. Early anesthesiologist and otolaryngologist consultation facilitates initial safe airway management, which is then followed by appropriate antibiotic treatment.

• #58 Epiglottitis Treatment & Management: Approach Considerations, Prehospital Care, Airway Management

  https://emedicine.medscape.com/article/763612-treatment

  Patients without signs of airway compromise, respiratory difficulty, stridor, or drooling, and who have only mild swelling on laryngoscopy, may be managed without immediate airway intervention by close monitoring in the intensive care unit (ICU). […] Close contacts of patients in whom Haemophilus influenzae type b is isolated should receive rifampin prophylaxis (20 mg/kg; not to exceed 600 mg/d for 4 d). […] Occurrence of recurrent episodes of acute epiglottitis in adults is unusual and, when present, warrants immune system investigation, because a quantitative or specific antibiotic deficiency may be present. Treatment of patients with recurrent acute epiglottitis may involve immunization or antibody replacement. […] An anesthesiologist and an ear, nose, and throat (ENT) specialist or a general surgeon should be notified as soon as possible when epiglottitis is suspected. Early anesthesiologist and otolaryngologist consultation facilitates initial safe airway management, which is then followed by appropriate antibiotic treatment.

• #59 Epiglottitis Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/epiglottitis.html

  Epiglottitis needs to be treated in the hospital so the person’s breathing can be monitored. If the person is having trouble breathing, he or she may need to have a breathing tube inserted in his or her throat. […] Antibiotics should be started immediately after breathing is stabilized and blood samples and throat swabs are taken. Antibiotics usually are given through an intravenous line (into a vein). Once the infection is under control, antibiotics can be taken by mouth until treatment is complete. Additional medicines may be given to control fever and pain. […] The following list of medications are related to or used in the treatment of this condition. […] With proper treatment, people usually recover completely. The key, however, is recognizing the symptoms early, so that treatment can be started before difficulties begin.

• #60 Epiglottitis: When to Call 911 for Windpipe Swelling

  https://www.verywellhealth.com/epiglottitis-7510173

  Complete recovery from epiglottis is possible, and the condition is rarely fatal. How quickly an adult or child recovers will depend on how soon medical treatment begins and if it is administered in a hospital setting. […] Epiglottitis is a medical emergency and requires immediate medical attention. It is not a condition that goes away on its own. Without treatment, it can progress to a life-threatening airway obstruction. […] Once treatment begins and the airway is safe, the disease typically stops progressing within 24 hours. Complete recovery might take longer and will depend on the severity of symptoms and the cause, but most people can heal and recover fully. […] Epiglottitis is an emergency medical condition that requires immediate treatment to avoid life-threatening airway obstruction. Most people recover from epiglottitis, but the condition might be fatal without treatment. Treatment aims to restore airway function, improve healing through IV fluids, treat the infection, and reduce swelling.

• #61 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  Supplemental blow-by oxygen should be administered while preparing for emergent airway management, which often includes controlled intubation or, in severe cases, needle cricothyroidotomy or tracheostomy. Ideally, emergency airway intervention should occur in the operating room to visualize the airway first with a laryngoscope. If endotracheal intubation is not feasible, a tracheostomy should be performed. After securing the airway, empiric antibiotics, such as cefuroxime, ceftriaxone, or cefotaxime, should be administered to cover common respiratory and oral pathogens. Due to heightened clinical awareness and improved protocols, pediatric death rates following intubation or airway control have dropped to less than 1%, though delays in transport or diagnosis still contribute to fatalities. […]

• #62 Epiglottitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430960/

  Otolaryngologic evaluation in adults is crucial to assess airway status and predict the risk of rapid progression. Many otolaryngologists recommend intensive care observation, antibiotics, and steroids for mild-to-moderate swelling in adults without high-risk factors like diabetes or epiglottic abscess. Inhalation induction, common in pediatric cases, has an unclear role in adults, and a backup tracheostomy plan should always be in place. […] […] Adult mortality from epiglottitis can reach 7% to 10%, which is much higher than in children. Neuromuscular blocking agent use remains controversial, as reduced airway tone may cause complete obstruction. Airway management failures in adults often result from: […] […] No consensus exists on the optimal management of adult epiglottitis due to varying clinical presentations, healthcare settings, expertise, and resources. Pediatric epiglottitis may be more straightforward to manage than adult cases, but successful treatment across all ages requires rapid, accurate diagnosis, proper identification of patients needing immediate airway control, anticipation of deterioration, and preparedness for front-of-neck airway access. While no definitive guide for airway management in this life-threatening condition exists, prompt and skilled intervention is essential to prevent fatal outcomes.

• #63 Epiglottitis

  https://www.nhs.uk/conditions/epiglottitis/

  If you have epiglottitis, you will need treatment in hospital. […] You’ll usually need oxygen through a tube in your nose or a face mask. […] You may also need to have a breathing tube either put down your throat or into a hole made in your neck (tracheostomy) if you’re finding it very difficult to breathe. […] You’ll also be given antibiotics through a vein if an infection has caused your symptoms. […] With treatment, most people will make a full recovery, but you may need to stay in hospital for a few days.

• #64 Epiglottitis: Causes, Symptoms, and Treatment

  https://patient.info/ears-nose-throat-mouth/epiglottitis-leaflet

  If treatment is not started quickly, the swelling of the epiglottis can totally block (obstruct) the airway. This means that air is not able to reach the lungs and this can cause collapse and death. […] With prompt treatment, most people recover in a few days and are able to leave hospital in about a week.

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