Pediatric Upper Airway Stridor-Croup-Epiglottitis

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PEDIATRIC UPPER AIRWAY STRIDOR-CROUP-EPIGLOTTITIS Escambia County, Florida - ALS/BLS Medical Protocol Stridor is a high pitched "crowing" sounds caused by restriction of the upper airway. In addition to FBAO, stridor can be caused by croup and epiglottitis. Croup (laryngotracheobronchitis) is a viral infection of the upper airway, which causes edema/ inflammation below the larynx and glottis with a resultant narrowing of the lumen of the airway. Croup most often occurs in children 6 months to 4 years of age. The child with croup will have stridor, as well as, a distinctive barking cough and cold symptoms (low-grade fever (100-101 degrees F), with a gradual onset of respiratory distress. Epiglottitis is an acute infection and inflammation of the epiglottis that potentially is life-threatening. Since the availability of Hemophilus influenza, type B (Hib) vaccine, epiglottitis has markedly decreased, yet it may still occur from other bacterial pathogens. Epiglottitis usually occurs in children 4 years of age and older. The child with epiglottitis will present with stridor, as well as, acute respiratory distress, sore throat, pain upon swallowing which causes the distinctive drooling, high grade fever (102-104 degrees F), and may assume the classic tripod position. Supportive Care 1. Medical Supportive Care Protocol, including pulse oximeter (avoid IVs in these patients) (a). 2. Avoid agitating the child with suspected epiglottitis. Never examine the epiglottis (a). 3. Administer humidified oxygen. If humidified oxygen is unavailable, use Approved: 10/01/2011 Approved by: Version: 3.1 Page 1 of 2 Charles Neal, D.O. Medical Director PEDIATRIC UPPER AIRWAY STRIDOR-CROUP-EPIGLOTTITIS Escambia County, Florida - ALS/BLS Medical Protocol nebulized saline (do not force oxygen mask on pediatric patient - use blow-by technique if necessary) (a). ALS Level 1 None ALS Level 2 (Physician Authorization Required) None Note (a) Avoid any procedure that will agitate patient. Approved: 10/01/2011 Approved by: Version: 3.1 Page 2 of 2 Charles Neal, D.O. Medical Director .

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Clinical Features of Acute Epiglottitis in Adults in the Emergency Department
대한응급의학회지 제 27 권 제 1 호 � 원저� Volume 27, Number 1, February, 2016 Eye, Ear, Nose & Oral Clinical Features of Acute Epiglottitis in Adults in the Emergency Department Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do1, Korea Kyoung Min You, M.D., Woon Yong Kwon, M.D., Gil Joon Suh, M.D., Kyung Su Kim, M.D., Jae Seong Kim, M.D.1, Min Ji Park, M.D. Purpose: Acute epiglottitis is a potentially fatal condition Key Words: Epiglottitis, Emergency medical services, Fever, that can result in airway obstruction. The aim of this study is Intratracheal Intubation to examine the clinical features of adult patients who visited the emergency department (ED) with acute epiglottitis. Methods: This retrospective observational study was con- Article Summary ducted at a single tertiary hospital ED from November 2005 What is already known in the previous study to October 2015. We searched our electronic medical While the incidence of acute epiglottitis in children has records (EMR) system for a diagnosis of “acute epiglottitis” shown a marked decrease as a result of vaccination for and selected those patients who visited the ED. Haemophilus influenzae type b, the incidence of acute Results: A total of 28 patients were included. There was no epiglottitis in adults has increased. However, in Korea, few pediatric case with acute epiglottitis during the study period. studies concerning adult patients with acute epiglottitis The mean age of the patients was 58.0±14.8 years. The who present to the emergency department (ED) have been peak incidences were in the sixth (n=7, 25.0%) and eighth reported.
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