Important points why epiglottitis is dangerous;
• Epiglottitis is a septic infection that can progress rapidly and be life-threatening. If the patient is dyspnea, a serious condition should be suspected.
• Epiglottite in children has been caused almost exclusively by type B bacteria called Haemophilus influenzae. Due to the widespread use of the Hib vaccine, Haemophilus epiglottite is rare nowadays.
• Haemophilus epiglottite is possible, although there are usual causative organisms of unvaccinated adult populations, which cause pneumococci, streptococci and staphylococci. In immunocompromised patients, epiglottite can be caused by fungi.
• Epiglottite is usually characterized by epiglottis swelling, including swelling of other structures on glottis (supraglottitis).
• An epiglottite patient will instinctively think the posture and lean forward to prevent that the inflated epiglot presses down and the airway obstruction.
• If epiglottitis is suspected, although symptoms are not important, but should be referred immediately to consult ENT (Ear Nose Throat) specialist. Patients with dyspnea and clear signs and symptoms of epiglottitis should be taken to the hospital. During the transfer, the patient must fit into the sitting posture, lean forward and be accompanied by a doctor. Throat assessment should usually be done by an ENT specialist because tongue depression, for example, can cause a life-threatening constriction of the inflamed throat.
• The airway of a dyspneic epiglottitis patient must be protected; the first-step approach is endotracheal intubation. Before attempting intubation, a plan should be made for the failure case of intubation. The gap between the thyroid and the cricoid cartilage should be palpated; this area is for emergency cricothyrotomy.