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3-11. Epiglottitis

Epiglottitis is a condition in which the epiglottis becomes inflamed. This inflammation is caused by a bacterial infection of the patient's epiglottis. The inflamed epiglottis swells and becomes a "cherry-red" color, resulting in an obstructed airway.

a. Signs/Symptoms of Epiglottitis. Children who have epiglottitis are usually over four years old. Signs and symptoms include the following:

(1) Pain on swallowing (dysphagia).

(2) Frequent drooling. The presence or absence of drooling is a way of differentiating this condition from croup. The child with croup will not be drooling.

(3) High fever, perhaps.

(4) Respiratory distress.

b. Treatment for Epiglottitis. Follow these procedures:

(1) Administer humidified oxygen.

(2) Initiate an IV of dextrose in water at the rate of 5 ml per kilogram of the child's weight. DO NOT spend a lot of time on starting an IV. If there is a problem inserting an IV, forget it and transport the patient to a hospital immediately!

(3) Let the child assume the position which is most comfortable for him.

(4) Transport the child to a medical care facility immediately. Epiglottitis can only be treated in a medical facility. Often (50 percent of the cases), the condition requires a tracheotomy or intubation.

CAUTION: Children with epiglottitis are in grave danger from airway obstruction. NEVER, NEVER, NEVER place an instrument in the mouth of a child with epiglottis. Anything put in the throat will cause severe laryngospasm, resulting in swelling which obstructs the airway.

Epiglottitis is a medical emergency! The child must be transported calmly and quickly to a hospital.

David L. Heiserman, Editor

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Revised: June 06, 2015