Welcome back to the Internet Book of Critical Care. I'm here with Adam Thomas, and we're

going to talk about epiglottitis. This one again gets filed under Pucker Factor. Epiglottitis,

Josh and I were just talking about. It can be one of the most humbling presentations because

it is the airway. It's the number one problem in our hierarchy

of things to address, but sometimes you don't know whether to intubate them up front or to wait

a little longer than you've waited too long. So today we'll cover signs symptoms, differential,

of course. We'll talk about airway management, which will be a big core of this podcast.

But of course, for infectious epiglottitis, we'll talk about antimicrobial therapy.

And with airway swelling, you can't get into it without a little steroids, can't be, Josh?

Absolutely not.

So let's get into signs and symptoms.

So in med school, I learned these patients are always drooling.

They're sitting forward

and they're telling you they have epiglottitis with their hot potato voice. That's true, correct?

This honestly seems like a really challenging diagnosis. So as an intensivist, my main symptom

that a patient has epiglottitis is when someone calls me from the ER and they say,

hey, Farcas, we have a patient with epiglottitis. Yeah, it's on the chart, yeah.

But seriously, the symptoms you're challenging, sore throat seems to be the most common one.

You can also have a variety of difficulty swallowing with anaphagia, dysphagia, drooling, much less common.

Voice change can be a useful one.

Because honestly, the real challenge here is sorting out epiglottitis, which is obviously a medical emergency, from a billion patients who simply have pharyngitis from virus or whatnot. So voice change can be useful, clue to kind of something

bad in the larynx, and also respiratory dysfunction strider dysmia, your tripod position, obviously bad.

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