Angelite Nurses: Epiglottitis

Epiglottitis

General information

Life-threatening bacterial infection of epiglottis and surrounding structures
Primary organism: H. influenzae, type B
Often preceded by upper respiratory infection
Rapid progression of swelling causes reduction in airway diameter; may lead to sudden respiratory arrest
Affects children ages 3-7 years

Assessment findings

Fever, tachycardia, inspiratory stridor, labored respirations with retractions, sore throat, dysphagia, drooling
Irritability, restlessness, anxious-looking
Position: sitting upright, head forward and jaw thrust out
Diagnostic tests

WBC increased
Lateral neck x-ray reveals characteristic findings

Nursing interventions

Provide mist tent with oxygen.
Administer IV antibiotics as ordered.
Provide tracheostomy or endotracheal tube care (see The Respiratory System - Traceostomy Care, in Unit 4); note the following

Restlessness, fatigue, dyspnea, cyanosis, pallor, tachycardia, tachypnea, diminished breath sounds, adventitious lung sounds.
Need for suctioning to remove secretions; note amount, color, consistency.

Reassure child through touch, sound, and physically being present.
Involve parents in all aspects of care.
Avoid direct examination of the epiglottis as it may precipitate spasm and obstruction.
Remember this is extremely frightening experience for child and parents; explain procedures and findings; reinforce explanations of physician.

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