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What Do I Do Now? Epiglottitis

Mike Weinstock, MD and Mizuho Morrison, DO
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Acute epiglottitis is a life threatening infection of the upper airway that is time sensitive to diagnose. Recognizing red flags of its presentation and also which patients in whom you need to consider it could be the difference between life and death.

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nicole h. -

Maybe you've already done this topic and I just haven't found it yet but I would be interested in procedures that are considered acceptable in the Urgent Care setting. Obviously not for this pt presented in the epiglottitis scenario but a review on needle aspiration for a PTA or steroid injections in knees, etc? Just a suggestion as I am always interested in more procedural pearls. Thank you and great job!

Mike W., MD -

Hi Nicole, thanks for the comments - this would be an excellent topic and thanks for the suggestion!

Charles M. -

Show notes should have included the final note about the importance of not attempting to visualize the posterior pharynx in a child in whom you suspect epiglottitis.

Mike W., MD -

Hi Charles,
Thx for your comment. This is what I was taught and this has also been by practice; not to visualize, but... lately with the decreased prevalence of infant and child epiglottitis, I have been visualizing more. I looked at Tintinalli and they state that there are no documented reports showing it to be unsafe. With adults, there are so many other causes of stridor (for example PTA), that I believe we should attempt visualization. If we stated in the program that we should not visualize, I apologize for this error. Thx again for your thoughts!

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Danger Zones Full episode audio for MD edition 191:20 min - 90 MB - M4AHippo Urgent Care RAP May 2016 Summary 540 KB - PDF