Clinical Practice Guidelines:

Respiratory/Epiglottitis
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Date April, 2016

Purpose To ensure consistent management of patients with Epiglottitis.
Scope Applies to all QAS clinical staff.
Author Clinical Quality & Patient Safety Unit, QAS
Review date April, 2018
URL https://ambulance.qld.gov.au/clinical.html

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 Epiglottitis
April, 2016

Epiglottitis, or supraglottitis, is an inflammation of the lining 


Clinical features
of the cartilaginous tissue that protects the airway during

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swallowing.
Infection of this structure is predominantly caused by the bacteria
Haemophilus influenzae. It can also be caused by other bacteria 

• High fever
• Sore throat/difficulty swallowing
• Stridor/respiratory distress
or viruses causing respiratory illnesses and non-infection
• Drooling
aetiologies.[1]
• Hoarse voice
Epiglottitis is a medical emergency. The throat should not be

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examined due to the risk of complete airway obstruction.
Epiglottitis is now very uncommon due to the routine Hib
immunisation given in childhood. It used to be most prevalent 

Risk assessment

in paediatric patients aged 2–6 years, but now is more common 
 • Any unnecessary disturbance of patient 

in adults due to streptococcus pneumoniae and viral pathogens, 
 including attempts to lie the patient down,
or children who are not vaccinated.[1] examination of the throat or insertion of 


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an IV cannula can precipitate total airway
obstruction.[2]

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Figure 2.51

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 CPG: Paramedic Safety
e

Additional information
CPG: Standard Cares
• Endotracheal tube intubation will be extremely
difficult due to intense swelling and

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inflammation of the epiglottis.

• In severe cases, complete airway obstruction • Do not visualise the airway

can rapidly develop within 3–6 hours.[2]
• Calm the patient
• Consider alternate causes: • Allow patient to assume
- Inhaled foreign body position of comfort
- Croup

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• Avoid IV access attempts
- Bacterial tracheitis unless active resuscitation
required.

Consider:
Note: Officers are 

• Oxygen only to perform 


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procedures for 

which they have 

received specific 

training and 

Transport to hospital
authorisation 

Pre-notify as appropriate by the QAS.

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