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- Epiglottitis has been eradicated since the introduction of the Hib vaccine (Hib as part of the 5 in 1 DTaP/IPV/Hib vaccine)
- vaccine: 2,3,4 months.Hib/Men C “booster” vaccine at 12 months.
- Pyrexia, sore throat, muffled speech, drooling and stridor
- sitting forwards neck extended, mouth open, drooling with tongue protruding
- Fibre-optic laryngoscopy remains the ‘gold standard’ for diagnosing epiglottitis, should only be performed in operating theatres which are prepared for intubation or tracheostomy in the event of upper airway obstruction.
- Lateral neck X-ray: ‘thumbprint sign’
- CT or MRI scans if abscesses suspected
- Blood culture, thorat swap if unwell
- Keep calm: Do not distress the child as this can precipitate complete airway obstruction
- Oxygen if hypoxic
- IV antibiotics if intravenous access can be achieved without distress
- call anesthetist with an ENT surgeon: Children under 6 years of age require urgent intubation, ideally in theatre
- Keep difficult intubation trolley and cricothyroidotomy kit must be ready.