Podcasts about Epiglottitis

Croup is a clinical syndrome of upper airway obstruction defined by barking cough, stridor, and hoarseness. Management hinges on severity assessment, universal corticosteroid use, and selective epinephrine. The key clinical task is distinguishing typical croup from high-risk mimics that require urgent airway intervention. Learning Objectives Differentiate croup from other causes of pediatric upper airway obstruction using key historical and physical exam features. Apply a severity-based approach to croup management, including appropriate use of corticosteroids and nebulized epinephrine. Recognize clinical features that suggest alternative or life-threatening diagnoses requiring escalation of care. References Cooke A, Conway S, Griffin L. Croup: Rapid Evidence Review. Am Fam Physician. 2026;113(3):254-258. Gates A, Johnson DW, Klassen TP. Glucocorticoids for Croup in Children. JAMA Pediatr. 2019;173(6):595-596. doi:10.1001/jamapediatrics.2019.0834 Bjornson CL, Klassen TP, Williamson J, et al. A Randomized Trial of a Single Dose of Oral Dexamethasone for Mild Croup. N Engl J Med. 2004;351(13):1306-1313. doi:10.1056/NEJMoa033534 Bjornson CL, Johnson DW. Croup. Lancet. 2008;371(9609):329-339. doi:10.1016/S0140-6736(08)60170-1 Bjornson C, Russell K, Vandermeer B, Klassen TP, Johnson DW. Nebulized Epinephrine for Croup in Children. Cochrane Database Syst Rev. 2013;(10):CD006619. doi:10.1002/14651858.CD006619.pub3 Transcript This transcript was generated using Descript and subsequently reviewed and lightly edited for spelling, grammar, and clarity. Minor inaccuracies may remain, and the audio recording should be considered the definitive version of this content.  Welcome to PEM Currents: The Pediatric Emergency Medicine Podcast. As always, I'm your host, Brad Sobolewski. And today we're gonna talk about croup. We're gonna focus on diagnosis, severity based management, and how to differentiate it from scarier high risk conditions that may present similarly, but behave very differently. So croup is best understood as a clinical syndrome of upper airway obstruction caused by inflammation at the level of the larynx and subglottis. So in most cases this is viral laryngotracheitis, most commonly due to parainfluenza virus. But as you'd expect multiple viruses can cause it. The subglottis is the narrowest portion of the pediatric airway. So even small amounts of edema create large increases in airway resistance. So that's why the clinical picture is so consistent. You've got inspiratory stridor, hoarseness, and that characteristic barking cough, which either sounds like a seal or a dog, and yes, of course, I know the difference between the two coughs because I was a biology major. This is primarily a disease of children between six months and three years of age with a peak incidence in the second year of life. It's really, really common, like one and a half percent of all ED visits, maybe 350,000 visits a year, and 85% of these kids have mild disease. Hospitalization is rare. The range is variable, about two to 8% of cases, and return visits occur in about three to 5%. Fewer than 1% of children, a lot fewer, require intensive care or airway intervention. Honestly, most kids do really well. The ones who don't can get sick very quickly, and that's been my clinical experience. In the Northern Hemisphere, we see croup throughout the fall and winter, usually starting in around November and sort of tapering off by April. But that being said, I've seen croup-like symptoms every month of the year over the past couple of decades. Croup is absolutely a classic clinical diagnosis. A typical case begins with 12 to 48 hours of viral prodrome, you know, body aches, fever, congestion, cough, followed by often abrupt nighttime onset of barky cough and stridor. Symptoms fluctuate, and they're generally worse with agitation and get better when the kid is calm. That variability is the key feature. So what you'll have is a child who wakes up after sleeping for a few hours with a barky cough and then noisy stridor. This freaks parents out, and this is not hyperbole. There's this little center in the back of your brain that's like, please don't stop breathing and die. So appropriately, they're worried about the kid, they call emergency medical services, they bring them to the emergency department, and by and large, by the time they get there, the stridor has resolved. The kid is calm, and parents will say, I swear he looked a lot worse at home. Trust me, we believe you parents, this is what croup does. When I'm taking a history of croup, I get all of these details. Are there any sick contacts? If the parents are worried about a foreign body inhalation or ingestion, then I'm worried about a foreign body inhalation or ingestion. Listen to the lungs, inspect their airway. Always check the ears for concomitant otitis and I'll feel their trachea. I'll actually grab and hold the trachea and move it. Kids with croup really don't have a painful trachea. Kids with bacterial tracheitis, aside from looking more toxic, actually have a lot of pain when they move their trachea. Testing for croup is generally unnecessary. Labs and viral studies do not change management, and imaging is really reserved for atypical presentations or when you're considering an alternative diagnosis like a foreign body. If you do get an X-ray, what you're looking for is the classic steeple sign on the AP view. It is seen in croup, but it's not 100% sensitive nor specific. Once you've made the diagnosis of croup, it's important to assess severity, and remember that I said that most kids are mild. So mild croup is defined by the absence of stridor at rest. So they may have some stridor when they're upset or even a little bit of hoarseness or noise. It's important to listen to many, many children with croup to get a sense of this. Moderate croup includes stridor at rest with mild to moderate retractions. So at rest means that the child is in a position of comfort. They're calm with a parent, and they've generally been that way for about 10 to 15 minutes. Sometimes that's how long it can take for the stridor to dissipate once you get the kid calm. Severe croup, which is fortunately rare, involves marked work of breathing, agitation, fatigue, need for oxygen, altered mental status, and this aligns with the Westley croup score. It formalizes stridor, retractions, air entry, cyanosis, and mental status. But really, in practice, most of us get very good at bedside assessment of croup. Management of croup starts with corticosteroids. This is one of the highest-yield interventions that we have in pediatric emergency medicine. Every child with croup should receive dexamethasone. Typically 0.6 milligram per kilogram as a single dose up to a maximum of 10 milligrams. Some places will use 0.15 milligram per kilogram. Locally, we often give the IV formulation orally. It's 10 milligrams per mL. Tastes bad, but pairs reasonably well with apple juice. The oral suspension is 1 milligram per mL, tastes terrible, and pairs nicely with being spit on the ground by toddlers. The evidence behind dexamethasone is very robust. The main benefit is that it reduces return visits and hospital readmissions by about half, and those return visits include doctor's offices and emergency departments. In a Cochrane review of 1,679 children, glucocorticoids reduce return visits or readmissions with a risk ratio of 0.52, so that translates to a number needed to treat of seven. I've certainly seen seven or more croup kids during one shift, so for every seven children treated with dexamethasone, one return visit is prevented. Symptom improvement begins within about two hours and lasts at least 24 hours, but maybe up to a couple of days. Hospital length of stay for kids that get steroids is reduced by an average of 15 hours as well. Serious adverse events are rare. It's well tolerated, and other than the taste, kids do fine with it. And importantly, the benefit is consistent across all severities of croup, mild, moderate, and severe. So when you explain this to families who are very scared about their kids, but now their kid is looking better and you're only giving them a single medicine, not doing any tests or X-rays or anything, I think you have to frame the medicine in terms of what it's going to do for them over the next couple of days. So one way of explaining this to families would be to say something like this is a steroid called dexamethasone. It reduces the swelling in your child's airway that's causing the barky cough and noisy breathing. Most children start feeling better within a couple of hours, and the benefit lasts at least a full day, if not longer. Without this medicine, about one in five children need to come back because symptoms get worse again. You really get two bad days with croup in most cases. With this medicine, the risk of returning drops to about one in 10, so it cuts the chance of coming back in half. We can expect your child's cough to start improving over the next day or two. Most children are feeling a lot better within 48 hours, though a little bit of hoarseness and cough can last for a week to about 10 days. So it's possible that when your child goes to sleep later tonight, they may experience that barking cough and noisy breathing again. They're almost certainly going to be upset. The steroid blunts enough of the swelling so that you are much more likely to have them free of distress and stridor, that noisy breathing, once you get them calm. So if they're upset, get them calm, and if in about 10 minutes the stridor and noisy breathing get better, that's the dexamethasone doing its job and you can safely stay home. For children with moderate or severe croup, we're gonna use nebulized racemic epinephrine. It works fast by reducing airway edema by constricting inflamed blood vessels. You'll see improvement in stridor and work of breathing often within 30 minutes. The effect is transient and largely gone by about two hours, and you need to do a structured reassessment at about 30 minutes after the racemic epinephrine. If the child's clearly better, continue that observation for up to two hours. If they're unchanged or worse, repeat the epinephrine and start thinking more carefully about your diagnosis and disposition. Because it's got such a short duration, that two hours after treatment is the most common time period, though some institutions and some children will need to be observed a little bit longer. If they remain well appearing with no stridor at rest, normal oxygenation, minimal work of breathing, and they can tolerate oral fluids, they can be discharged. If symptoms recur, they require repeated epinephrine, or they fail to improve, then you may have to escalate care and consider admission. Honestly, with croup, supportive care is still one of the most important things. You gotta keep kids calm by minimizing agitation. Parents are experts at this with their own children. Agitation worsens airway obstruction. Airway resistance is fourfold greater when the kid's upset. Give oxygen if the kid's hypoxic. Fortunately, this is rare. Antipyretics and fluids are great, do them. Humidified air has not been shown to provide meaningful benefit, and obviously we should avoid sedatives because they can suppress respiratory drive without improving airway patency. Many parents will say that their kid was better when they were exposed to cool air or mist in the shower. Those can help, but honestly, don't stick your kid's head in the freezer if it upsets them. Keep them calm, hold them, and comfort them. Alright, croup, barking cough, stridor, variable symptoms, easy, right? There are some other diagnoses that can mimic this or overlap that you shouldn't miss. Spasmodic croup is a related phenotype. You've got sudden nighttime onset, often minimal prodrome, and recurrent episodes. These kids are typically well between episodes, and the pattern becomes more apparent over time. Some kids will bark with every mild cold or stuffy nose up until about eight or nine, but they usually don't have stridor and respiratory distress. Bacterial tracheitis is progression to a more severe and dangerous airway infection. These children often start with viral symptoms and then rapidly worsen. They've got a high fever, they appear toxic. Most importantly, they fail to respond to standard croup therapy. Toxic appearance plus lack of response should immediately shift your diagnostic reasoning. These kids may have a lot of pain when you grab and move their trachea. The cough can be more junky because again, they've got purulent mucus in their trachea. Epiglottitis is defined by the absence of barking cough and the presence of drooling, dysphagia, and tripod positioning. These children are very anxious, they're very ill, their airway is at risk, and so your immediate priority is keeping them calm and having the airway managed in the safest environment, generally the operating room. Deep neck space infections, including retropharyngeal cellulitis and abscesses and peritonsillar abscesses, present with fever, neck stiffness, sometimes even torticollis, and lymphadenopathy. Kids won't really have a barky cough and the exam localizes to the neck rather than the airway alone. Acute foreign body aspiration presents with sudden onset symptoms, no viral prodrome, no barking cough, and sometimes some asymmetric exam findings. The diagnosis is frequently missed when clinicians anchor too early on croup. If you have an esophageal foreign body, remember that 70% of these get stuck at the thoracic inlet. So always think about a kid who sounded like they had croup and got croup treatments, but also has some swallowing issues and is the right age to put things in their mouth. This is when you see coins and button batteries and other things stuck not in the upper airway, but in the esophagus right behind it. Alright, now when it comes to disposition, most kids with croup are gonna be sent home. Children who improve, they have no stridor at rest, minimal work of breathing, can be discharged home with clear return precautions. Those with persistent symptoms, need for repeated racemic epinephrine, hypoxia, or concerning features should be admitted. For kids who continue to worsen despite standard therapy, escalation includes high-flow nasal cannula, noninvasive ventilation as a bridge. Heliox can be used as a temporizing measure to reduce work of breathing. Fortunately, needing to intubate a child with croup is rare, but when it's needed, it can be challenging due to subglottic narrowing. You need the best proceduralists, and you should downsize your endotracheal tube by 0.5 to 1 millimeter smaller than usual. And I'll reiterate this again. The natural course of croup is really favorable for most kids. The fear's not gonna go away for the parents, this is a scary diagnosis, but I think with some reassurance, we can help them understand that this is something that is unlikely to cause significant problems and will get better. Most kids improve significantly within 48 hours, though like any other respiratory illness, symptoms can persist for a week or so. Severe outcomes are fortunately rare, and they almost always occur in children whose severity or alternative diagnosis was not recognized early. So again, here's my take-home points. Croup is a clinical diagnosis. Severity determines your management. Steroids, dexamethasone, should be given to all patients. Racemic epinephrine is used for moderate to severe disease with mandatory reassessment and observation. And most importantly, always reassess the diagnosis when the presentation does not fit the expected patterns. Things can get rough when you're barking up the wrong tree and thinking it's croup when it's actually something else. Well, I hope you enjoyed this episode on honestly one of the most classic conditions that we see in the pediatric emergency department. If you've got any feedback on the episode, send it my way. As the kids would say, like, rate, and review. I would love it if you left a review on your favorite podcast site. It helps more people find the show. I do this as a labor of love because I enjoy teaching, and I think that this is a wonderful way to reach my colleagues and learners. If you've got suggestions on other topics or episodes, I'd love to hear them. For PEM Currents: The Pediatric Emergency Medicine Podcast, this has been Brad Sobolewski. See you next time.

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Epiglottitis from the Pediatrics section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

This episode covers epiglottitis.Written notes can be found at https://zerotofinals.com/paediatrics/respiratory/epiglottitis/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.

Acute Sore Throat explained, including different causes including strep throat and peritonsillar abscess, with treatment of each. Also includes common associated symptoms as well as more worrying symptoms and a viral vs bacterial scoring system for acute sore throat. Consider subscribing on YouTube (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 What is a sore throat?0:30 Sore Throat Symptoms1:50 Tonsillopharyngitis / Acute Pharyngitis / Strep Throat4:34 Infectious Mononucleosis 5:37 Peritonsillar Abscess (Quinsy) 7:04 Parapharyngeal Abscess & Retropharyngeal Abscess8:42 EpiglottitisReferences:1. BMJ Best Practice (2024) “Acute Pharyngitis”. Available at https://bestpractice.bmj.com/topics/en-gb/5/2. Cheng, A.G - MSD Manual Pro (2024) “Tonsillopharyngitis”. Available at https://www.msdmanuals.com/professional/ear,-nose,-and-throat-disorders/oral-and-pharyngeal-disorders/tonsillopharyngitis#Symptoms-and-Signs_v9468593. Laura Sauve, A - Canadian Paediatric Society (2021) “Group A streptococcal (GAS) pharyngitis: A practical guide to diagnosis and treatment”. Available at https://cps.ca/en/documents/position/group-a-streptococcal4. Efi Mantzourani (2022) - “Characteristics of the sore throat test and treat service in community pharmacies (STREP) in Wales: cross-sectional analysis of 11 304 consultations using anonymized electronic pharmacy records”. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780525/#:~:text=Acute%20sore%20throat%20is%20a%20common%20presentation%20in,GABHS%20and%20viral%20infections%20is%20less%20accurate.%2011 5. ENTSHO (2022) - “Acute Sore Throat”. Available at https://entsho.com/triage-acute-sore-throat6. Watkins, R - Geeky Medics (2024) - “Rheumatic Fever”. Available at  https://geekymedics.com/rheumatic-fever/7. Kenneth, M.K - MSD Manual Pro (2023) - “Infectious Mononucleosis”. Available at https://www.msdmanuals.com/professional/infectious-diseases/herpesviruses/infectious-mononucleosis8. Cheng, A.G - MSD Manual Pro (2024) - “Epiglottitis”. Available at https://www.msdmanuals.com/professional/ear,-nose,-and-throat-disorders/oral-and-pharyngeal-disorders/epiglottitisPlease remember this podcast and all content from Rhesus Medicine is meant for educational purposes only and should not be used as a guide to diagnose or to treat. Please consult a healthcare professional for medical advice. 

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In this podcast, Dr. Gabi Hester, a pediatric hospitalist and Quality Improvement (QI) medical director for Children's Hospitals of Minnesota in Duluth, brings her knowledge and experience in  everything related to croup and bronchiolitis (specifically pertaining to in-patients and to frontline healthcare providers). *Dr. Gabi Hester, speaker for this educational event, has disclosed that she is a consultant who provides content recommendations to AvoMed. All relevant financial relationships for Dr. Hester have been mitigated.  Enjoy the podcast. Objectives:Upon completion of this podcast, participants should be able to: State at least 2 challenges in the recognition of and treatment of acute respiratory illnesses in children. Describe potential interventions for bronchiolitis that have not been shown to provide signigicant benefit to most patients. Recognize common "mimickers" of croup. 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We apologize for the inconvenience.)  DISCLOSURE ANNOUNCEMENT  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview.  Any re-reproduction of any of the materials presented would be infringement of copyright laws.  It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker's outside interest may reflect a possible bias, either the exposition or the conclusions presented. None of Ridgeview's CME planning committee members have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.  All of the relevant financial relationships for the individuals listed above have been mitigated. Thank-you for listening to the podcast. SHOW NOTES:   *See the attachment for additional information.  PODCAST OVERVIEW CROUP (layngotracheitis)Overview - 400,000 approx. ER visits/year in U.S. - Costly, approx. $53 million/year - Scary disease due to airway obstruction - Para-influenza most common - Classically, kids are admitted after 2 racemic epinephrine nebulizers         - Dr. Hester studied croup and hospitalization (see resources below)         - Kids admitted, and no further treatment or intervention (observed) Presentation and treatment - Rhinorrhea, low grade fever, barky cough (seal bark)- Inspiratory stridor, usually worse when agitated - Rarely insp and exp stridor (if progressed disease state) - Dexamethason 0.6 mg/kg (max dose of 12-16 mg) - Nebulized racemic epinephrine (RA)       - bridge for steroid to kick in      - reserved for stridulous patient - Think about croup mimics       - not responding to racemic epinephrine       - older kids (i.e. 7 yr old), think about other diagnoses       - Epiglottitis            - cough is less barky            - respiratory distress and tripoding            - thumb print sign       - Bacterial tracheitis            - can be complication of viral croup            - can quickly decompensate - Foreign body, airway anomalies, etc. TREATMENT: - cool outdoor air can be soothing, no good studies to support - humidified air - imaging can be done (steeple sign on AP neck) but not routinely required         - Worried about foreign body? Epiglottitis?         - not responding to racemic epi         - CXR if hypoxia. Not typical of croup to be hypoxia.Research (links below) - Most kids don't need further treatment after ED course. -

In this episode of the Survival Medicine Podcast, Dr. Joe Alton and Nurse Practitioner Amy Alton proudly announce their first children's book, "Snowbie, the first snowman," a heartwarming story of how snowmen came to be, great Christmas bedtime reading for little ones! Reading to children helps develop listening, vocabulary, social, and other skills that last well into their teens. Check out Snowbie here: Snowbie: The First Snowman: Alton A.R.N.P., Amy, Alton M.D., Joseph, Crouthamel, Cheryl: 9781510780675: Amazon.com: Books Plus, Dr. Bones discusses pneumonia, whooping cough, epigottitis, and other respiratory infections that come out in the cold weather months (part of a series). Also, his thoughts on bartering in survival settings, and why you should have more medical supplies that you currently have in your storage! Lastly, a question from a listener about inflammation of the prostate. What is it and how is it treated? All this and more in the latest Survival Medicine Podcast with Joe and Amy Alton! Wishing you the best of health in good times or bad, The Altons Hey, don't forget to check out our entire line of quality medical kits and individual supplies at store.doomandbloom.net. Also, our Book Excellence Award-winning 700-page SURVIVAL MEDICINE HANDBOOK: THE ESSENTIAL GUIDE FOR WHEN HELP IS NOT ON THE WAY is now available in black and white on Amazon and in color and color spiral-bound versions at store.doomandbloom.net.

Download for FREE today -  special Mnemonics Cheatsheet - so you can be SURE that you have that Must Know information down:  bit.ly/nursing-memory   Outline AIR RAID A-Airway Closed I-Increased Pulse R-Restlessness   R-Retractions- occur when the muscles between the ribs pull inward A-Anxiety I-Increased Inspiratory Stridor- high-pitched breath sound resulting from turbulent airflow in the larynx D-Drooling Description The epiglottis is a flap of cartilage that covers the entrance to our airway when we swallow food. Inflammation of the epiglottis can close off the airway entirely.

Featuring (in order of appearance) Dr Reuben Strayer Dr Narain Verma Show notes available at ⁠podcast.RnRRounds.ca

As they say in the business, video killed the radio star. This week is our grand opening of our Video podcast. You can now see our smiling faces on Youtube, TikTok, and other social media outlets as we cover a classic pediatric pathology- Epiglottitis! Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 183. Epiglottitis: video killed the radio star. https://www.emboardbombs.com/podcasts/183-epiglottitis-video-killed-the-radio-star. July 9th, 2023. Accessed [date]

The epiglottis is the toilet seat of the airway. That's a useful function. But what if becomes so swollen and inflamed that it leads to airway obstruction and respiratory failure. That's bad. That's also what epiglottitis is. You can also call it supraglottitis. Either way you need to recognize this potentially life threatening malady and […]

Für Eltern und Kind ist eine Atemnotsituation bei „viralem Krupp“ etwas sehr Beängstigendes. Experte PD Dr. Tobias Ankermann, Kinderpneumologe und Chefarzt der Städtischen Kinderklinik in Kiel, hebt im Gespräch mit Moderator Dr. Axel Enninger hervor, was wichtig ist, wenn die Regio subglottis bei einem kleinen Kind infektionsbedingt anschwillt. Zunächst heißt es Ruhe ausstrahlen, unnötige Interventionen vermeiden und das Kind mit dem typischen bellenden „Krupphusten“ und inspiratorischen Stridor aufrecht hinsetzen. Doch welche Differenzialdiagnosen sollte man ausschließen und was sind Warnzeichen für eine Verschlechterung? Spielt Feinstaub tatsächlich eine Rolle und gibt es Evidenz für verbreitete Tricks wie die Zufuhr feucht-kühler Luft? Gut zu wissen: Die meisten Fälle sind mit Glukokortikoiden, am besten als Saft gegeben, gut beherrschbar. Literatur: Die Neuauflage des Consilium Themenheftes „Krupp“ von PD Dr. Tobias Ankermann finden Sie voraussichtlich im Herbst auf der Lernplattform www.wissenwirkt.com. Die AWMF-Leitlinie „Stenosierende Laryngotracheitis (Krupp) und Epiglottitis“ aus dem Jahr 2006 ist abgelaufen und wird zurzeit überarbeitet. Studien zu Auswirkung von Luftverschmutzung auf die Atemwege: Garcia E, Berhane KT, Islam T et al. (2019) Association of changes in air quality with incident asthma in children in California, 1993-2014. Jama 321(19) 1906–1915. Wichmann HE, Hübner HR, Malin E et al. (1989) Die Bedeutung gesundheitlicher Risiken durch “outdoor pollution,” erläutert anhand der Querschnittstudien zum Pseudokrupp in Baden-Württemberg. Öff Gesundh-Wes 51 414–420. Englischer Abctract: https://pubmed.ncbi.nlm.nih.gov/2531323/   Information für Eltern Patientenratgeber „Krupp“, InfectoPharm Arzneimittel und Consilium GmbH In deutscher und türkischer Sprache erhältlich. PDF zum Download: https://www.infectopharm.com/fuer-patienten/patienten-ratgeber/krupp/ Kontakte: Feedback zum Podcast? podcast@infectopharm.com Homepage zum Podcast: www.infectopharm.com/consilium/podcast/ Für Fachkreise: www.wissenwirkt.com und App „Wissen wirkt.“ für Android und iOS Homepage InfectoPharm: www.infectopharm.com Disclaimer: Der consilium – Pädiatrie-Podcast dient der neutralen medizinischen Information und Fortbildung für Ärzte. Für die Inhalte sind der Moderator und die Gäste verantwortlich, sie unterliegen dem wissenschaftlichen Wandel des Faches. Änderungen sind vorbehalten.

In this episode, we review the high-yield topic of Epiglottitis from the Pediatrics section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

The epiglottis is a flap of cartilage that covers the entrance to our airway when we swallow food. Inflammation of the epiglottis can close off the airway entirely.  

In **Folge 58** bleiben wir noch ein bisschen beim Kehlkopf. Wir kümmern uns um die Pathologie, nämlich um die Laryngitis (Pseudokrupp und Epiglottitis) und die Kehlkopfdiphterie, den echten Krupp. Viel Spaß beim Zuhören und Lernen ;-) Falls du Mitglied werden und den Podcast unterstützen möchtest, geht es hier zu den Monats- und Jahrespaketen: https://steadyhq.com/wissensreise Den Youtube-Kanal findest du hier: https://www.youtube.com/channel/UCvJEv1PMae-i4ey_274tbwQ Das Preismodell für das Coaching findest du unter www.tanjas-naturheilkunde.com/lerncoaching. Hier findest du auch den Link, um ein kostenloses Erstgespräch online zu buchen. Schreib mir gerne Anregung, Kritik, eine Coaching-Anfrage oder einfach nur ein "Hallo", auch an die Adresse: tanjaloiblhp@gmail.com. Auf Instagram findest du mich unter: tanjas_naturheilkunde

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast with Brit Long, MD (@long_brit), we cover epiglottitis. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

The JournalFeed podcast for the week of August 15-19, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Non-Op Stabbings Spoon Feed: In abdominal stab wound patients without criteria for immediate operative intervention, 24 hours of observation was sufficient to identify a failure of conservative management. Adult Epiglottitis Spoon Feed This review article offers pearls for adult epiglottitis, a disease with increasing prevalence and high morbidity.

Dr. Shari Welch discusses various methods to improve ED performance.  From engaging leadership to metrics, Shari gives helpful tips to implement which help with emergency department  efficiency. This episode comes from our Innovations in ED Management  Course. Learn more at https://courses.ccme.org/course/innovationsined

Take home points: Epiglottitis has demonstrated a resurgence in the adult population. It is no longer a pediatric only disease. The classic presentation of epiglottitis (3Ds of drooling, dysphagia and distress) is uncommon Epiglottitis should be high on your differential for the bounce-back patient who continues to complain of worsening sore throat Definitive diagnosis is ... Read more The post REBEL Core Cast 69.0 – Epiglottitis appeared first on REBEL EM - Emergency Medicine Blog.

Today, we begin the first of a four part series where we dive into the deaths of all 40 US presidents throughout history. From Asthma, to Epiglottitis, to Typhoid Fever, the deaths of the first 10 presidents are full of mystery and intrigue. This is NOT your physician's podcast. Hosts Shane Garrettson and Cal Vandergrift dive into the pharmacy world with fun, interesting, and downright weird topics! Tune in for NEW episodes, available on Spotify, Apple, Anchor, and more! Check out our Facebook, Twitter, and Instagram pages at Let's Pharmonize to view videos and images relevant to every episode! If you have any questions, comments, or even corrections, e-mail us at pharmonization@gmail.com. PLEASE READ: Shane, Kelly and Cal are NOT medical professionals. DO NOT USE the information presented in this podcast to aid in your own personal health or medicinal benefit. This is a light-hearted podcast that should not be taken with the same seriousness as your own personal health. A special thanks to Kelly Kerr for creating the music used in the intro and outro. Additional music and sound by Fesliyan Studios. --- Support this podcast: https://anchor.fm/calvin-vandergrift8/support

Welcome to Episode 007 (cue the James Bond music please) of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 7 of “The 2 View” A Wolf in Sheep's Clothing Birnbaumer, Diane MD. A Wolf in Sheep's Clothing: Serious Causes of Common Complaints. Advanced Emergency Medicine Boot Camp. September 2019. Las Vegas. Accessed June 29, 2021. Subarachnoid Hemorrhage Carpenter CR, Hussain AM, Ward MJ, et al. Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis Describing the Diagnostic Accuracy of History, Physical Examination, Imaging, and Lumbar Puncture with an Exploration of Test Thresholds. Acad Emerg Med. PubMed.gov. Published September 6, 2016. Accessed June 29, 2021. https://pubmed.ncbi.nlm.nih.gov/27306497/ Connolly ES Jr, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke. Published 2012. Accessed June 29, 2021. https://www.ahajournals.org/doi/full/10.1161/str.0b013e3182587839 Headache. Acep.org. Published June 2019. Accessed June 29, 2021. https://www.acep.org/patient-care/clinical-policies/headache/ Hine, J MD, Marcolini, E MD. Aneurysmal Subarachnoid Hemorrhage. EM:RAP CorePendium. Emrap.org. Published September 17, 2020. Accessed June 29, 2021. https://www.emrap.org/corependium/chapter/recTI59VW0TPBpesx/Aneurysmal-Subarachnoid-Hemorrhage Kim YW, Neal D, Hoh BL. Cerebral aneurysms in pregnancy and delivery: pregnancy and delivery do not increase the risk of aneurysm rupture. Neurosurgery. PubMed.gov. Published February 2013. Accessed June 29, 2021. https://pubmed.ncbi.nlm.nih.gov/23147786/ Marcolini E, Hine J. Approach to the Diagnosis and Management of Subarachnoid Hemorrhage. West J Emerg Med. NCBI. Published February 28, 2019. Accessed June 29, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404699/ Ogilvy, C MD, Rordorf, G MD, Singer, R MD. Aneurysmal subarachnoid hemorrhage: Clinical manifestations and diagnosis. UpToDate. Uptodate.com. Updated February 25, 2020. Accessed June 29, 2021. https://www.uptodate.com/contents/aneurysmal-subarachnoid-hemorrhage-clinical-manifestations-and-diagnosis?search=subarachnoid%20hemorrhage&source=searchresult&selectedTitle=1~150&usagetype=default&display_rank=1 Ottawa Subarachnoid Hemorrhage (SAH) Rule for Headache Evaluation. Mdcalc.com. Accessed June 29, 2021. https://www.mdcalc.com/ottawa-subarachnoid-hemorrhage-sah-rule-headache-evaluation Subarachnoid Hemorrhage, no LP. EM:RAP. Emrap.org. Published May 2020. Accessed June 29, 2021. https://www.emrap.org/episode/emrap2020may/subarachnoid Gonococcal Arthritis Klausner, J MD, MPH. Disseminated gonococcal infection. UpToDate. Uptodate.com. Updated January 7, 2021. Accessed June 29, 2021. https://www.uptodate.com/contents/disseminated-gonococcal-infection Li R, Hatcher JD. Gonococcal Arthritis. In: StatPearls. StatPearls Publishing. Published July 26, 2020. Accessed June 29, 2021. https://www.ncbi.nlm.nih.gov/books/NBK470439/ Milne, Wm. MD. SGEM#335: Sisters Are Doin' It for Themselves…Self-Obtained Vaginal Swabs for STIs. Thesgem.com. Published June 26, 2021. Accessed June 29, 2021. https://www.thesgem.com/2021/06/sgem335-all-by-myselfself-obtained-vaginal-swabs-for-stis/ Ventura, Y MD, Waseem, M MD, MS. Disseminated Gonococcal Infection: Emergency Department Evaluation and Treatment. Emdocs.net. Published May 17, 2021. Accessed June 29, 2021. http://www.emdocs.net/disseminated-gonococcal-infection-emergency-department-evaluation-and-treatment/ Epiglottitis Abdallah C. Acute epiglottitis: Trends, diagnosis and management. Saudi J Anaesth. Published July-September 2012. Accessed June 29, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498669/ Ames WA, Ward VM, Tranter RM, Street M. Adult epiglottitis: an under-recognized, life-threatening condition. Br J Anaesth. Oxford Academic. Published November 1, 2000. Accessed June 29, 2021. https://academic.oup.com/bja/article/85/5/795/273886 Dowdy RAE, Cornelius BW. Medical Management of Epiglottitis. Anesth Prog. Published July 6, 2020. Accessed June 29, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342809/ Farkas, J. Epiglottitis. Emcrit.org. Published December 18, 2016. Accessed June 29, 2021. https://emcrit.org/ibcc/epiglottitis/ Mayo-Smith M. Fatal respiratory arrest in adult epiglottitis in the intensive care unit. Implications for airway management. Chest. PubMed.gov. Published September 1993. Accessed June 29, 2021. https://pubmed.ncbi.nlm.nih.gov/8365325/ Roberts, J MD, Roberts, M ACNP, PNP. Nasal Endoscopy for Urgent and Complex ED Cases. Lww.com. Published October 28, 2020. Accessed June 29, 2021. https://journals.lww.com/em-news/blog/theproceduralpause/pages/post.aspx?PostID=110 Wolf M, Strauss B, Kronenberg J, Leventon G. Conservative management of adult epiglottitis. Laryngoscope. PubMed.gov. Published February 1990. Accessed June 29, 2021. https://pubmed.ncbi.nlm.nih.gov/2299960/ Wellens Syndrome Wellens Syndrom EKG Sign: See full show notes here: https://bit.ly/3eSyzp0 Cadogan M, Buttner R. Wellens Syndrome. Life in the Fastlane. Litfl.com. Published June 4, 2021. Accessed June 29, 2021. https://litfl.com/wellens-syndrome-ecg-library/ Smith S. Wellens' missed. Then returns with Wellens' with dynamic T-wave inversion. Dr. Smith's ECG Blog. Blogspot.com. Published May 4, 2011. Accessed June 29, 2021. http://hqmeded-ecg.blogspot.com/2011/05/wellens-missed-then-returns-with.html?m=1 Wellens Syndrome ECG Recommended Book Resources for the Month Merck. The Merck Manual of Patient Symptoms. (Porter RS, ed.). Merck; 2008. Schaider JJ, Barkin RM, Hayden SR, et al., eds. Rosen and Barkin's 5-Minute Emergency Medicine Consult. 4th ed. Lippincott Williams and Wilkins; 2010. Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Last month we asked you a trivia question regarding the very first NP program – who was the duo that began the program and what was the first NP specialty program? The correct answer was Dr. Loretta Ford and Dr. Henry Silver. The first NP specialty program was pediatrics. We'll be sending Lindsey Harvey, MSN, FNP-BC to the November Original EM Boot Camp Gratis for providing that answer! We can't wait to see you and all of the other registrants in November in Las Vegas! Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to.

Epiglottitis is a life threatening inflammation of the epiglottis, classically caused by Haemophilus influenzae (Hib), but other pathogens can cause it too, and should especially be considered if an immunised individual presents with epiglottitis.  The most important thing initially is to avoid distressing the child, as this could worsen airway obstruction. It is an emergency and requires early escalation in order to secure an airway. Listen in to find out more about the presentation, management and other causative pathogens!   Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingrightpod@gmail.com Make sure you hit SUBSCRIBE/FOLLOW so you don't miss out on any pearls of wisdom and RATE if you can to help other people find us! (This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

Written By: Chris Cochrane Expert Review By: Dr. Nabeela Waja (Paediatrician) https://thegenerehlist.ca/2021/06/06/ccfp-key-topic-croup/ Objective 1: In patients with croup, Identify the need for respiratory assistance (e.g., assess ABCs, fatigue, somnolence, paradoxical breathing, in drawing) and provide that assistance when indicated.     Objective 2: Before attributing stridor to croup, consider other possible causes (e.g., anaphylaxis, foreign body (airway or esophagus), retropharyngeal abscess, epiglottitis). Objective 3: In any patient presenting with respiratory symptoms, look specifically for the signs and symptoms that differentiate upper from lower respiratory disease (e.g., stridor vs. wheeze vs. whoop). Objective 4: In a child presenting with a clear history and physical examination compatible with mild to moderate croup, make the clinical diagnosis without further testing (e.g., do not routinely X-ray). Objective 5: In patients with a diagnosis of croup, use steroids (do not under treat mild-to-moderate cases of croup). Objective 6: In a patient presenting with croup, address parental concerns (e.g., not minimizing the symptoms and their impact on the parents), acknowledging fluctuating course of the disease, providing a plan anticipating recurrence of the symptoms.

Dr. Diane Birnbaumer breaks down ED cases in which patients present common complaints, initially appearing benign, which mask serious illnesses. This episode comes from our Advanced EM Boot Camp Course which focuses on in-depth topics that will help you become a master practitioner.   Take the Advanced EM Boot Camp course online or live in Las Vegas — both versions are fully CME accredited and are guaranteed to help you provide the best care for your patients.   Learn more at https://courses.ccme.org/course/advancedbootcamp

Eine weitere lebensrettende Folge des erste Hilfe Podcast. Podcast hören, Leben retten! Folgt mir gerne auf Instagram (kevinmaeckmeyer) und besucht mich in meinem Phönix-Shop auf www.kevinmaeckmeyer.com

In this episode, we cover the rare but life threatening Epiglottitis.  Highlights: Presentation not as you learned in medical school Vast majority do not need intubation, but for those that due it can be catastrophic Nasolaryngoscopy, Steroids, broad spectrum antibiotics and early airway plans are the way to go

This episode covers epiglottitis.Written notes can be found at https://zerotofinals.com/paediatrics/respiratory/epiglottitis/ or in the respiratory section in the Zero to Finals paediatrics.The audio in the episode was expertly edited by Harry Watchman.

Contributor: Michael Hunt, MD Educational Pearls: Due to the efficacy of vaccination, epiglottitis is now more common in adults than children Risk factors include smoking and other immunocompromising co-morbidities, such as diabetes Epiglottitis can present with sore throat and fever, with potential rapid progression to respiratory distress and stridor Diagnosis can include x-ray to look for the “thumbprint sign," nasofiberoptics, and/or CT Antibiotics are mainstay of treatment but severe cases may need establishment of a definitive airway, typically done with fiberoptics in the operating room due to the potential to irritate the epiglottitis with traditional laryngoscopy References Li RM, Kiemeney M. Infections of the Neck. Emerg Med Clin North Am. 2019 Feb;37(1):95-107. doi: 10.1016/j.emc.2018.09.003. Review. PubMed PMID: 30454783. Tsai YT, Huang EI, Chang GH, Tsai MS, Hsu CM, Yang YH, Lin MH, Liu CY, Li HY. Risk of acute epiglottitis in patients with preexisting diabetes mellitus: A population-based case-control study. PLoS One. 2018;13(6):e0199036. doi: 10.1371/journal.pone.0199036. eCollection 2018. PubMed PMID: 29889887; PubMed Central PMCID: PMC5995441. Guerra AM, Waseem M. Epiglottitis. [Updated 2018 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430960/ Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD

Take Home Points on Epiglottitis Epiglottitis has demonstrated a resurgence in the adult population. It is no longer a pediatric only disease. The classic presentation... The post REBEL Core Cast 11.0 – Epiglottitis appeared first on REBEL EM - Emergency Medicine Blog.

Coming out of NUH DREEAM Dr Tom Stubington, CT2 in ENT, joins the pod to walk us through sore throats, the common causes and management including: - Tonsilitis and Quinsy - Glandular fever - CENTOR and FeverPAIN scores - Epiglottitis and Supraglottitis - Jamie learning he can do a decent impression of a 'hot potato' voice You can find the blog entry including the #TakeVisually for this episode at https://www.takeaurally.com/ear-nose-throat/2018/7/22/sore-throat-in-ed Remember to subscribe to Take Aurally on iTunes or SoundCloud Both Take Aurally and NUH DREEAM can be found on Facebook and Twitter

Podcast summary of articles from the May 2018 edition of Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include D-dimer evaluation for Pulmonary Embolism, Propofol for pediatric headaches, Diabetic Ketoacidosis treatment in adults, a case report on a toxidrome in pregnancy and board review on pharyngitis mimics.  Guest speaker is Dr. Prashanth Swamy from the Metrohealth Emergency Medicine Residency.

This week on Humerus Hacks Sarah is joined by guess-expert Tava to talk about causes of acute shortness of breath in kids! A special paediatric episode, wheeze be striding through allllll them common conditions.   Email us questions at humerushacks@gmail.com Like our Facebook page 'Humerus Hacks' Follow us on Twitter @humerushacks

Dr. Leeor Sommer who runs ENT hands-on workshops and Dr. Maria Ivankovic, lecturer extraordinaire on ENT emergencies discuss ENT Emergencies Pearls, Pitfalls, Tips & Tricks: Dr. Ivankovic's stepwise approach to managing epistaxis including the best local anesthetics, the use of ice to decrease nasal flow, who requires antibiotics, the management of hypertension in epistaxis, tranexamic acid for nose bleeds and managing posterior bleeds, tips for nasal and ear foreign body removal including the use of tissue adhesive, how to pick up and work up the dreaded Malignant Otitis Externa including key diagnostic pearls the best tests, sudden sensorineural hearing loss ('The Bells' Palsy of the Ear') including how to save a patient from losing their hearing, Epiglottitis including diagnostic clues and imaging findings, Pharyngitis work-up and treatment: Do we need to work-up and treat with antibiotics at all? & The Toronto Throat Score, Tips and Tricks for peritonsillar abscess drainage, Hereditary and ACE-inhibitor associated Angioedema presentations and management including the use of C1 Esterase inhibitors. The post Episode 38: ENT Emergencies Pearls, Pitfalls, Tips and Tricks appeared first on Emergency Medicine Cases.

Dr. Leeor Sommer who runs ENT hands-on workshops and Dr. Maria Ivankovic, lecturer extraordinaire on ENT emergencies discuss ENT Emergencies Pearls, Pitfalls, Tips & Tricks: Dr. Ivankovic's stepwise approach to managing epistaxis including the best local anesthetics, the use of ice to decrease nasal flow, who requires antibiotics, the management of hypertension in epistaxis, tranexamic acid for nose bleeds and managing posterior bleeds, tips for nasal and ear foreign body removal including the use of tissue adhesive, how to pick up and work up the dreaded Malignant Otitis Externa including key diagnostic pearls the best tests, sudden sensorineural hearing loss ('The Bells' Palsy of the Ear') including how to save a patient from losing their hearing, Epiglottitis including diagnostic clues and imaging findings, Pharyngitis work-up and treatment: Do we need to work-up and treat with antibiotics at all? & The Toronto Throat Score, Tips and Tricks for peritonsillar abscess drainage, Hereditary and ACE-inhibitor associated Angioedema presentations and management including the use of C1 Esterase inhibitors. The post Episode 38: ENT Emergencies Pearls, Pitfalls, Tips and Tricks appeared first on Emergency Medicine Cases.

Dr. Leeor Sommer,who runs annual ENT workshops in Toronto give us his Best Case Ever involving an Extubation in the ED gone bad. In the related Episode 38 - ENT Emergencies - Pearls & Pitfalls, Tips & Tricks, Dr. Leeor Sommer and Dr. Maria Ivankovic, lecturer extrodinaire on ENT emergencies discuss: Dr. Ivankovic's stepwise approach to managing epistaxis, Tips for nasal and ear foreign body removal, How to pick up and work up the dreaded Malignant Otitis Externa, Sudden sensorineural hearing loss ('The Bells' Palsy of the Ear'), Epiglottitis work-up and management, Pharyngitis work-up and treatment - Does anyone with phayrngitis need antibiotics?, Tips and Tricks for peritonsillar abscess drainage, Hereditary and ACE-inhibitor associated Angioedema presentations and management. The post Best Case Ever 19: Extubation in the ED appeared first on Emergency Medicine Cases.

Shortness of breath is a chief complaint that we encounter each day in the ED.  This chief complaint encompasses a huge differential and this is a long podcast.  As always, I'll break this chief complaint down into the diagnoses that we can't miss and how to treat the underlying causes of shortness of breath for both kids and adults.

Learn the normal anatomy seen on the lateral neck radiograph and review the findings in 4 common diseases diagnosed on this view