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Wednesday, October 19, 2022

Epiglottitis

emDOCs Podcast / Episode 64 - By Britt Long - October 18, 2022
Pearls:
  • More common in adults who present with odynophagia, dysphagia, and over a more subacute time frame
  • Normal 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