Epiglottitis Lecture Notes

Introduction

• Presenter: Cereth, Registered Nurse
• Topic: Epiglottitis
• Series: Part of the NCLEX review series on Pediatric Nursing
• Additional Content: Access to a free quiz related to the condition

What is Epiglottitis?

• Definition: Inflammation of the epiglottis
• Consequences: Can lead to an upper airway obstruction, a medical emergency
• Affected Population: More common in pediatric patients, but adults can also be affected

Understanding the Epiglottis

• Location: Hinged piece of cartilage at the back of the tongue, inside the thyroid cartilage
• Function: Closes the entryway to the trachea during swallowing to prevent aspiration
• Normal Function: Stays open during breathing to allow air flow
• Issues with Inflammation:
  • Airway obstruction
  • Difficulty swallowing
  • Muffled or soft voice

Causes of Epiglottitis

• Transmission: Spread by infectious droplets
• Common Bacteria:
  • Haemophilus influenzae type B (most common)
  • Streptococcus pneumoniae
• Prevention: Vaccine available for Haemophilus influenzae type B (Hib vaccine)
  • Doses: 3 to 4 doses depending on the brand
  • Schedule: Administered at 2, 4, 6 months, and 12-15 months

Signs and Symptoms

• Mnemonic: "Add Air Nurse" for upper airway obstruction
  • A: Abnormal position (tripod position)
  • D: Dysphagia (difficulty swallowing) leading to drooling
  • D: Difficulty speaking (muffled or soft voice)
  • A: Apprehension (irritability, anxiety)
  • I: Increased temperature (high fever)
  • R: Rapid onset of symptoms
  • N: Nasal flaring
  • U: Using accessory muscles to breathe
  • R: Retractions (visible rib cage when breathing)
  • S: Stridor (inspiratory, high-pitched sound)
  • E: Enlarged epiglottis visible on x-ray
• Note: Cough is usually not present

Nursing Interventions

• Assessment Cautions:
  • Never insert anything into the mouth (no tongue blades, oral temperatures, or throat cultures)
  • Presence of crash cart and intubation equipment
  • Do not leave patient alone
  • Monitor oxygen status, respiratory effort, breath sounds, oxygen saturation, color, and heart rate
  • Look for signs of hypoxia (e.g., tachycardia)
• Calming Techniques:
  • Keep child with parent
  • Avoid restraints
  • Maintain calm environment
  • Allow tripod position and avoid supine position
• Medical Management:
  • Nothing by mouth
  • Administer IV fluids, antibiotics, antipyretics, and corticosteroids

Prevention

• Hib Vaccine: Key to preventing epiglottitis
• Education: Ensure parents are informed about vaccination schedules

Conclusion

• Reminder: Take the free quiz
• Call to Action: Subscribe for more educational videos

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The lecture provides comprehensive information about epiglottitis, including causes, symptoms, prevention, and nursing interventions. Understanding these key points is crucial for managing pediatric patients with this condition. For further study, refer to the mnemonic "Add Air Nurse" to recall symptoms and the significance of the Hib vaccine in prevention.