Master Epiglottitis Assessment with Picmonic for Medicine

Haemophilus influenzae, usually type b, is the bacterial organism responsible for epiglottitis. The Hib vaccine prevents disease from this organism and should be given to infants in three to four divided doses starting at the age of two months.

Patients may exhibit drooling due to difficulty swallowing (dysphagia) secondary to supraglottic inflammation and building obstruction.

Because epiglottitis is caused by Haemophilus influenzae, the patient’s body will respond to the infection with an elevated temperature, as part of the immune response. Characteristically, fevers associated with this condition are often high.

Stridor, an abnormal, high-pitched breath sound, may be heard on inspiration. Stridor typically indicates extreme compromise of the airway and should be treated as an emergency.

Respiratory distress can lead to restlessness due to apprehension of obtaining a full breath, building carbon dioxide in the serum (hypercapnia) and the sensation of throat tightening.

Difficulty breathing, or dyspnea, is commonly seen in patients with epiglottitis, due to inflammation and obstruction of the airway.

The patient with epiglottitis may cough as a reflex to superior throat irritation or the drainage into the bronchial airway. The presence of a cough does not explicitly indicate epiglottitis vs other pharyngeal or upper airway disease processes but is a result of pathology in the location of the epiglottis.

Patients who are in respiratory distress may assume the tripod position in an effort to optimize breathing. In this position, the patient will lean forward with the chin extended and mouth open with tongue protruding.

Epiglottitis is an emergency for pediatric patients, and possibly for adult patients with increasingly compromised airway secondary to the disease process. The presence of an advanced airway capability should be readily available should comprehensive airway obstruction occur.

If epiglottitis is suspected, do not attempt visual inspection of the pharynx unless immediate intubation is possible. Attempting visual inspection with or without scope capabilities increases the risk of comprehensive airway closure secondary to either obstruction or spasm of the airway.