Epiglottitis


  1. General information
    1. Life-threatening bacterial infection of epiglottis and surrounding structures
    2. Primary organism: H. influenzae, type B
    3. Often preceded by upper respiratory infection
    4. Rapid progression of swelling causes reduction in airway diameter; may lead to sudden respiratory arrest
    5. Affects children ages 3-7 years
  2. Assessment findings
    1. Fever, tachycardia, inspiratory stridor, labored respirations with retractions, sore throat, dysphagia, drooling
    2. Irritability, restlessness, anxious-looking
    3. Position: sitting upright, head forward and jaw thrust out
    4. Diagnostic tests
      1. WBC increased
      2. Lateral neck x-ray reveals characteristic findings
  3. Nursing interventions
    1. Provide mist tent with oxygen.
    2. Administer IV antibiotics as ordered.
    3. Provide tracheostomy or endotracheal tube care (see The Respiratory System - Traceostomy Care, in Unit 4); note the following
      1. Restlessness, fatigue, dyspnea, cyanosis, pallor, tachycardia, tachypnea, diminished breath sounds, adventitious lung sounds.
      2. Need for suctioning to remove secretions; note amount, color, consistency.
    4. Reassure child through touch, sound, and physically being present.
    5. Involve parents in all aspects of care.
    6. Avoid direct examination of the epiglottis as it may precipitate spasm and obstruction.
    7. Remember this is extremely frightening experience for child and parents; explain procedures and findings; reinforce explanations of physician.

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