Abstract
Awake intubation is frequently described in the literature as the preferred method for securing the airway in adult patients with epiglottitis, whereas children with epiglottitis are usually intubated following an inhalational induction. However, if topicalization is difficult due to the presence of an abscess or an uncooperative patient, an inhalational induction may still be a reasonable approach in the adult patient. In a review of the literature, only one recent case report had been found describing an inhalational induction with video laryngoscopy. However, this attempt was unsuccessful, mandating the need for a surgical airway. Our case report describes a successful inhalational induction and video laryngoscope intubation without the use of a paralytic agent in an adult patient with an epiglottic abscess and moderate airway stenosis.
Highlights
Acute epiglottitis is a life-threatening condition that requires prompt recognition and management
Awake intubation is frequently described in the literature as the preferred method for securing the airway in adult patients with epiglottitis, whereas children with epiglottitis are usually intubated following an inhalational induction
If topicalization is difficult due to the presence of an abscess or an uncooperative patient, an inhalational induction may still be a reasonable approach in the adult patient
Summary
Acute epiglottitis is a life-threatening condition that requires prompt recognition and management. The second case was successful after an intravenous induction of propofol and succinylcholine This was reported to be the first successful intubation of an adult patient with epiglottitis using video laryngoscopy [9]. We report our airway management approach for a patient with acute epiglottitis presenting for direct laryngoscopy and drainage of an epiglottic abscess. A 33-year-old woman presented to the emergency department overnight with a one-day history of odynophagia, pharyngitis, dysphonia, dyspnea precipitated by lying down, hoarseness, drooling, and generalized malaise Her medical history was significant for tobacco dependence, recent discovery of pregnancy, marijuana use (prior to pregnancy), and tonsillectomy as a child.
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