So welcome back to the Internet Book of Critical Care Podcast. I'm here with Adam Thomas, and we're going to talk about angioedema.

And this one's awesome because you've got your two-prong approach. We're going to spend very little time on histamine-mediated angiadema because we'll cover that in the anaplexus and the

bulk of today's podcast will be that bradokine mediated angioma and to be honest i have more fun

thinking about this anyway so josh let's get straight into it overview why can angiotema the

entrance to the body and swelling thereof from mouth to anus be a problem.

It can be a problem for a variety of reasons. It can cause GI symptoms. It can mimic acute

abdomen. But for us, this is really an issue with regards to airway protection and exphyxiation.

That's really why critical care folks are going to get involved.

And I guess the other important differentiator is to say if you're just treating histamine

mediated and you're shocked that your patient's not getting better over a couple days, it's

because you're missing the point and it's a totally different pathway.

So that being said, let's talk about the diagnosis of angioma.

It's pretty straightforward.

You got a patient who looks brutally uncomfortable.

Maybe they have some obvious

swelling of their mucous membranes. But what about those patients that is not clear? I can't

really see some swollen lips or tongue. The vast majority of these folks is going to be super

obvious. But occasionally you will encounter people with a potential diagnosis or presumed

diagnosis who do not have observable edema. And for those

folks, you really need to nail down this diagnosis. So if the patient is not intubated,

the best way to do this is to directly inspect the airway, either with a nasopharyngeal flexible

scope or with a parochoscopy, depending on what you have, or if the patient is intubated,

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