ACUTE EPIGLOTTITIS- The classical presentation of acute epiglottitis is welldescribed. It is of a toxic child with a sho history of sorethroat, inspiratory stridor, muffled voice and droolingdue to odynophagia and dysphagia. Left untreated thereis progressive respiratory distress. The child is febrile. It is commonest between the ages of 2 and 8 Nebulized epinephrine (1mL of 1 in 1000 epinephrinediluted in 3mL of 0.9% saline) has an established role inthe acute paediatric airway in reducing mucosal oedemaby an alpha-agonist effect causing vasoconstriction andbronchodilation; a maximum effect is achieved within30-60 minutes. It may postpone or eliminate the need for an aificial airway, or give symptomaticrelief until effective treatment can be given.
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