Epiglottis Essay

1208 Words3 Pages
bulb-icon

Recommended: Reflection on tracheostomy

Acute epiglottis is an infectious disease of the epiglottis and supraglottic structures that can cause sudden fatal airway obstruction. Airway management can be unpredictably difficult and challenging particularly in the event of the unexpected difficult airway. In rare cases, it is impossible either to intubate the trachea or to ventilate the lungs via mask. By anticipating these challenges and choosing the correct rescue strategy in managing the high-risk airway can increase the likelihood of a successful outcome. We report a case of a 41-year-old man presented with severe upper airway obstruction following acute epiglottis that urgently needed artificial airways. The complexities and the challenges encountered in managing the patient’s airway are discussed. Acute epiglottitis or often referred as “supraglottitis” is an infectious disease of the epiglottitis and surrounding supraglottic structures . Acute epiglottis has capable of rapid progression to complete airway obstruction as great as 18%, therefore achievement of airway patency remain the key elements in the airway management. There is no consensus on the optimum management of adult epiglottitis, however most literatures advocate immediate airway intervention in all patients with imminent or actual airway obstruction . We here highlight the challenges of the airway management in a patient of acute epiglottitis with upper airway obstruction and further emphasize the need of multidisciplinary approach including emergency physicians, ENT and anesthetics involvement. A 41-year-old manwith a history of DM was brought to emergency department (ED)due to difficulty in breathing. It was associated with fever, severe sore throat and muffled voice for 2 days duration. He visited a... ... middle of paper ... ...icothyroidotomy is going to be a challenge. Therefore, a tracheostomy is an ideal method, acknowledging the limitations described above especially when experienced ENT surgeon is available at the bedside. In conclusion, early diagnosis followed by an appropriate airway intervention is essential to prevent cardiac arrest or irreversible brain damage that occurs within minutes of complete airway obstruction. Although the conventional techniques remains standard option, every physician has to be familiar with the process of evaluating a difficult airway and, in the event of the unanticipated difficult airway and be able to use a wide variety of techniques to avoid complications and fatality. Airway management of the patient requires a coordinated effort from other consultants or colleagues, if available, can be the key to success in some circumstances.

Show More
Related

  • The Toughing Housewife Case Study

    533 Words  | 2 Pages

    The risk factors that Jessica presented with are a history that is positive for smoking, bronchitis and living in a large urban area with decreased air quality. The symptoms that suggest a pulmonary disorder include a productive cough with discolored sputum, elevated respiratory rate, use of the accessory respiratory muscles during quite breathing, exertional dyspnea, tachycardia and pedal edema. The discolored sputum is indicative of a respiratory infection. The changes in respiratory rate, use of respiratory muscles and exertional dyspnea indicate a pulmonary disorder since there is an increased amount of work required for normal breathing. Tachycardia may arise due to the lack of oxygenated blood available to the tissue stimulating an increase in heart rate. The pedal edema most probably results from decreased systemic blood flow.

    Read More

  • Case Study of a Patient with Chronic Obstructive Pulmonary Disease

    564 Words  | 2 Pages

    The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)

    Read More

  • Is Oral Care an Effective Intervention for Reducing the Incidence of Pneumonia in Mechanically Ventilated Patients?

    695 Words  | 2 Pages

    VAP develops in a patient after 48 hours or more of endotracheal intubation. According to a study by Relio et al. (as citied in Fields, L.B., 2008, Journal of Neuroscience Nursing, 40(5), 291-8) VAP adds an additional cost of $29,000-$40,000 per patient and increases the morality rate by 40-80%. Mechanically ventilated patients are at an increased risk in developing VAP due to factors such as circumvention of body’s own natural defense mechanisms in the upper respiratory tract (the filtering and protective properties of nasal mucosa and cilia), dry open mouth, and aspiration of oral secretions, altered consciousness, immobility, and possible immunosuppression. Furthermore, the accumulation of plaque in the oral cavity creates a biofilm that allows the patient’s mouth to become colonized with bacteria.

    Read More

  • Acute Exacerbation in Copd

    672 Words  | 2 Pages

    Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.

    Read More

  • Ventilator Associated Pneumonia ( Vap )

    709 Words  | 2 Pages

    Ventilator-associated pneumonia (VAP) remains to be a common and potentially serious complication of ventilator care often confronted within an intensive care unit (ICU). Ventilated and intubated patients present ICU physicians, nurses, and respiratory therapists with the unique challenge to integrate evidence-informed practices surrounding the delivery of high quality care that will decrease its occurrence and frequency. Mechanical intubation negates effective cough reflexes and hampers mucociliary clearance of secretions, which cause leakage and microaspiration of virulent bacteria into the lungs. VAP is the most frequent cause of nosocomial infections and occurs within 48 hours of intubation. VAP is a major health care burden with its increased morbidity, mortality, longer ventilator days and hospital stay, and escalating health care cost.

    Read More

  • Laminitis Essay

    2294 Words  | 5 Pages

    The majority of clinical cases of laminitis occur at pasture where there is an accumulation of rapidly fermentable non-structural carbohydrates (NSC) such as fructans, simple sugars or starches (Geor, 2010). Pasture-associated laminitis has major economic and welfare implications in the equine sector. Increased risk factors include insulin resistance, increased insulin secretory response, hypertriglyceridaemia and obesity (Asplin, et al., 2007;Carter, et al., 2009 and de Laat, et al., 2010). Insulin resistance has been associated with a number of problems in the horse, most notably laminitis. Insulin resistance can be defined as a physiological condition in which cells have a diminished response to normal actions of the hormone insulin. Insulin is produced but the cells become resistant and are less capable in transporting glucose from the bloodstream to muscle and other tissues. In horses, insulin resistance is associated with a number of diseases such as Equine Metabolic Syndrome (Powell, et al., 2002; Hoffman, et al., 2003;Vick, et al., 2006 and Frank, et al., 2009), Equine Cushing Disease (McGowan, et al., 2004 and Walsh, et al., 2009) and Laminitis (Treiber, et al., 2006;Bailey, et al., 2007;McGowan, 2008 and Geor, 2008). Obesity and insulin resistance in ponies has become a common problem and there is a growing awareness on the role that diet and exercise has to play (Jeffcott, et al., 1986; Frank, et al., 2006 and Vick & Adams, 2007). Over-expressed adipocytokines, such as leptin, have been suggested to impair insulin signalling and cause the up regulation of inflammatory cytokines. This then further contributes to impaired insulin signalling and endothelial dysfunction (Radin, et al., 2009). The restriction of energy throu...

    Read More

  • Myocardial Infarction Case Study

    4095 Words  | 9 Pages

    An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen

    Read More

  • Dehydration Essay

    605 Words  | 2 Pages

    The patient is a 55-year-old man admitted to the hospital for dehydration secondary to vomiting. The physical examination of the patient revealed dry mucous membranes and vital signs as follows: Pulse 110, blood pressure 100/60, and respirations of 20.

    Read More

  • Case Study on a Three Year Old With Bronchiolitis

    1885 Words  | 4 Pages

    Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...

    Read More

  • CPR

    331 Words  | 1 Pages

    The next step is to open the airway. Place two or three fingers under each side of the jaw, at its angle. Lift the jaw upward and outward. If this alone does not open the airway, slightly tilt the child’s head. Check for signs of breathing by using the look, listen, and feel method. Also, check for anything that may be blocking the airway. If something is visible, remove it.

    Read More

  • Chronic obstructive pulmonary disease (COPD)

    3105 Words  | 7 Pages

    Person, A. & Mintz, M., (2006), Anatomy and Physiology of the Respiratory Tract, Disorders of the Respiratory Tract, pp. 11-17, New Jersey: Human Press Inc.

    Read More

  • Chronic Bronchitis Essay

    783 Words  | 2 Pages

    Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.

    Read More

  • Nursing Diagnosis

    882 Words  | 2 Pages

    Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...

    Read More

  • Reflection of My Experience with Culturally Sensitive Care

    1369 Words  | 3 Pages

    Patient profile: Heterosexual Muslim Woman who has been in the United Stated for three years. She came from Pakistan. She is 42 forty-two years old, from low socioeconomic standing, English language barrier, and is Muslim rituals and practices. She came to emergency department with her husband due to shortness of breathing, high fever, severe cough. She was dignosed with new onset of pneumonia and currently on antibiotic. she also has history of Vitamin D deficiencies and diabetes mellitus type II. She admitted to medical-surgical floor for observation...

    Read More

  • Medical Report: Food Poisoning

    1184 Words  | 3 Pages

    The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.

    Read More

More about Epiglottis Essay

Open Document