Hey guys, this is EM Basic, and I'm your host for today, Tony Ziddick, emergency medicine physician

from Miami, Florida. I'm going to talk to you today about sore throat. And if you're thinking

that a sore throat is not really an emergency problem, well, you are almost always correct. Most sore

throats should be dealt with in a primary

care office, an urgent care center, or without any medical encounter at all. However, a small

percentage of patients who present to the ED with a sore throat are actually harboring a life-threatening

illness. In this episode, we'll

talk about how to distinguish the mundane sore throat from the potentially life-threatening

sore throat. Initial approach. When you enter the room of a patient whose chief complaint is sore throat,

as usual you're going to start with the ABCs. In particular, for a patient with a sore throat,

you're going to focus on the airway. You can quickly assess the airway by asking the patient a question.

If they can respond to your question with clear speech and they aren't working hard to breathe,

you can proceed with a full history and physical examination.

History.

The questions you should ask a patient with a sore throat should be designed to accomplish

two primary tasks. Number one, to identify patients who are harboring some sort of life-threatening

illness such as epiglottitis or retroferential abscess. And number two, for the patients who

don't have any of those life-threatening causes of sore throat, to distinguish viral pharyngitis

from strep pharyngeitis from other causes of sore throat.

With regards to identifying life-threatening causes of sore throat, the presence of a complaint of shortness of breath should concern you that something such as a mass or a deep space abscess could be impinging on the airway.

Your typical case of infectious pharyngitis should not cause

shortness of breath, although in rare cases the tonsils may be so swollen from tonsillof

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