emDocs
emDocs - March 12, 2022 - By Rachel Bridwell / Reviewed by: Alex Koyfman; Brit Long
Pearls
- More common in adults who present with odynophagia, dysphagia, and over a more subacute time frameNormal oropharynx occurs in 90% of adults with epiglottitis
- Lateral neck radiographs are a screening tool which may show the thumbprint or vallecula sign though have a high false positive rate
- Factors associated with increased rates of intubation are diabetes mellitus, symptoms over 12-24 hours, stridor, drooling, tachypnea, hypercarbia, epiglottic abscess, and subglottic extension
- Airway management has shifted from intubation/surgical airway in the operating room to awake fiberoptic intubation
- Corticosteroids and nebulized epinephrine may assist in decompensating patients, but the literature is controversial