Epiglottitis (supraglottitis): Management
- Charles R Woods, MD, MS
Charles R Woods, MD, MS
- Professor of Pediatrics
- University of Louisville School of Medicine
- Section Editors
- Gary R Fleisher, MD
Gary R Fleisher, MD
- Editor-in-Chief — Adult and Pediatric Emergency Medicine
- Section Editor — Pediatric Signs and Symptoms
- Egan Family Foundation Professor
- Harvard Medical School
- Ron M Walls, MD, FRCPC, FAAEM
Ron M Walls, MD, FRCPC, FAAEM
- Editor-in-Chief — Adult and Pediatric Emergency Medicine
- Section Editor — Adult Resuscitation
- Neskey Family Professor of Emergency Medicine
- Harvard Medical School
- Brigham and Women's Hospital
- Glenn C Isaacson, MD, FAAP
Glenn C Isaacson, MD, FAAP
- Section Editor — Pediatric Otolaryngology
- Professor, Departments of Otolaryngology, Head and Neck Surgery and Pediatrics
- Lewis Katz School of Medicine at Temple University
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
The treatment and prevention of epiglottitis will be reviewed here. The clinical features and diagnosis of epiglottitis are discussed separately. (See "Epiglottitis (supraglottitis): Clinical features and diagnosis".)
Epiglottitis is inflammation of the epiglottis and adjacent supraglottic structures . Without treatment, epiglottitis can progress to life-threatening airway obstruction. A rapid overview of the recognition and management of epiglottitis in children is provided in the table (table 1).
Maintenance of the airway is the mainstay of treatment of patients with epiglottitis. In patients with signs of total or near-total airway obstruction, airway control necessarily precedes diagnostic evaluation. The diagnostic evaluation of epiglottitis in children and adults is discussed in detail separately. (See "Epiglottitis (supraglottitis): Clinical features and diagnosis", section on 'Diagnostic criteria'.)
Epiglottitis should be suspected in young children, especially those who are un- or under-immunized against Haemophilus influenzae, type b (Hib) and who present with the characteristic clinical features as follows:
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- APPROACH TO AIRWAY MANAGEMENT
- Immediately manage the airway and involve airway specialists
- Patient not able to maintain airway
- - Bag-valve-mask ventilation
- - Oxygenation not maintained
- - Oxygenation maintained
- Patient able to maintain airway
- ANTIMICROBIAL THERAPY
- ADDITIONAL THERAPIES
- ONGOING CARE
- ADDITIONAL EVALUATION
- SUMMARY AND RECOMMENDATIONS