EPIGLOTTITIS and COVID-19: URTIs Causes, Symptoms and management
hello I hope you’re well and in this session we’re going to do upper respiratory tract infections again focusing on epiglotitis and COVID 19 my name is Uni Ber and if you’re new we encourage you to subscribe but also to watch all the way to the end and leave a comment if you’re returning member and you’ve not yet subscribed please do so so for those who are joining our sessions this YouTube channel focuses on lessons lectures and sometimes we do bring experts who talk about healthcare so be with us if this is your area of interest so we began explaining different uh upper respiratory tract infection and you can refer back to our various um classes to just learn more about including um sinitis um we talked about adenoditis tonsilitis and so on basically among the many upper respiratory tracts that are considered important so for the respiratory system we have two segments we have the upper respiratory tract and then we have the lower respiratory tract so on the upper respiratory tract this is where we got the nasal cavity we have the fernx we have the larynx and in here is where we are focusing for the upper respiratory tract and you have highlighted several illnesses pertaining to this that for some we’ve already discussed so we’ve already done rhinitis fngitis sinitis laryngitis tonsillitis and adenoditis so in this class we’re going to focus on epiglotitis and covid 19 now you may be wondering what about the lower respiratory tract for the lower respiratory tract the illnesses are very many and we’ve actually handled majority of them so if you refer to our playlist that we have written in our channel that is the respiratory disorders you get to meet different diseases that affect the lower respiratory tract including pneumonia asthma status asthmaticas we’ve also discussed on um bronchitis bronchulitis we’ve also done lung cancer basically we have expandedly checked on all these illnesses pertaining to lower respiratory tract so you can like listen in check more there read refer and get to understand how the lower respiratory tract illnesses behave both in terms of pathophysiology clinical manifestations signs and symptoms and even the management but in this class we would like to just focus on two illnesses and that is fiblotitis and covid 19 so let’s begin with epiglotitis so epiglotitis is coming from the term epiglotus and epiglotus is a a flap of a tissue that is at the base of our tongue and it’s normally important that it prevents food from entering the trachea so when the epig epiglotus gets inflamed we get a disease we call epiglotitis so in simple term we can say epiglotitis is the inflammation of the epiglotus pigglotus is a flap of tissue that is found at the base of the tongue and it’s normally exist to prevent food from entering the track here also again just like where we mentioned in the in the case of the previous illness in the adenoditis that it affects children normally children aged 1 to 5 years commonly affects them but it can also happen in adults so we are told epiglotitis has an abrupt onset and the condition can occur mostly during cold season or season where the weather is very cold the temperatures are very low like winter seasons it tends to lead to high epiglotitis rates it’s normally considered an emergency situation because it can progress rapidly to completely block the airway or obstruct it and because of this you can be treated as an emergency illness to just um work on how we can open the airways and to allow allow air to get back now looking at the anatomy where is the epiglotus located and how does it look like when it is now inflamed so we like to refer to our respiratory system here like we saying we are focusing on the upper respiratory system so we got the tongue and as we’re going downwards then we get to meet the epiglotus the flap of tissue that closes the track air when we need to swallow so this is our healthy epiglotus here so when it covers the the respiratory system part the first part that get covered is our vocal cord then the trachea automatically it’s covered but then when there’s epiglotitis this this tissue gets to the inflam inflamed so it swells up and because of this it can’t properly like do its role so because it’s well it’s swollen automatically it blocks the airways and because of this the child or the client is not able to breathe well so causes of epiglotitis it can vary from v viruses to bacteria however we have the common virus that causes epiglotitis and this includes the hemophilus influenza type B which normally is known for a viral infection we like to call influenza but then we have um thermal injuries like in case someone has inhaled heat it can also cause inflammation and the pig piglotus can swell up there’s also injection of corrosive chemicals which can also react in form of inflammation and autoimmune status where the person can suffer from autoimmunity and it can stimulate some reactive effects that can lead to inflammation and swelling now if you want to check if the epiglotus is undergoing inflammation then we can also do a direct v visualization by the use of a langoscope where we use a lingoscope to just check directly on the epiglotus if it’s swollen if it’s tender if it’s tender because of the process of inflammation you can use the lingoscopy procedure for that but then we come to clinical manifure ation how does the disease manifest itself so one of the clinical manifestation that we can look at here if the case of sore throat the patient can also present with agitation you can have tachicardia takipia so tachicardia this is increase in heart rate and then tipia this is increase in the breathing rate but this is a client that can also show signs of drooling difficulty or pain during swallowing so remember the case of dysfia where we are talking about client struggling to swallow because of the pain around the the neck area or the inflammation of the tissues around the neck there’s also a global sensation or a feeling of a lump in the fourth area of course this is due to the swolleness of the epiglotus at that particular time this client can also present with dysphonia that is muffled up voice or loss of voice at the end of the day so dysphonia is uncomfortable because the client is not able to pronounce words clearly or they’re not able to pronounce words well or the vocal cord get also to lose their abilities the patient can have dry or no coughs but then this now presents the symptoms of dysmia in other moment you can get fever or increase in temperatures you can have case of fatigue or mallay then in other cases you can have tripod sniffing postures for the children with a noisy breathing that is striders so this is a list of the clinical manifestation that can present up in an epiglotitis client from the case of th sore throat agitation or irritability tachicardia that is increased heart rate takipia that is increased breathing rate difficult in swallowing or painful swallowing global sensation dysphonia dysnia fever malaysian fatigue the sniffing uh posture and strider so these are manifestations that can be observed in an epiblotitis client now when it comes to management of epiglotitis remember we mentioned that this is usually treated as an emergency because remember when the pigot big piglotis swells it’s going to block the larynx and the tracha so that means air is not flowing easily or it’s not going through the respiratory system so this client can have very high chances of suffocating or going through hypoxia so number one when you discover this client has epiglotitis it’s advised that you immediately admit them to the facility that you can observe them and undergo critical interventions but then while this is happening you avoid any form of instrumentation like no insertion of depressors or other instrument that can provoke airway passives and lead to further respiratory compromise there’s also need to monitor any form of respiratory fatigue either by virtually assessing visually sorry assessing the client or continuously checking via the pulse oximter that the client oxygen levels are not going low so we’ll need to always have an oximter monitor on this client and then we are advised to avoid supine position as normally this can affect their respiratory uh status we know that with supine it means the client is um sleeping on their back so when the client sleeps on their back it means the chest cavity is reduced so they can’t properly take in enough air to promote gaseous exchange so avoid super position and then have equipment and personnel available for immediate incubation if it’s needed remember while the epiglotus keeps on swelling it’s blocking the larynx and it’s blocking the track air so in this case our client can be at risk of respiratory distress so have emergency setup put in advance in case you’re worried that this gland can go through distress and then start introvenous antibiotics after you have collected specimen for culture and sensitivity so start IV antibiotics to start clearing any form of viruses or bacterias that you’re questioning but then there’s an advice of medication that we can initiate in case you’re worried about hemophilus influenza including sept triagon or the use of third generation sephalosporins we can also do sephorexims or you can have sephals so these are options of choices that can be implemented to assist with with clearing of infection that is leading to piglotitis look at at fluids volume so in this case is correct fluid deficits with IV fluids again this can help us clear any form of excess mucus production so you can get fluids to help with clearing loosening this mucus and enabling clearance or drooling it out we are informed to avoid any sedatives and the reason we avoiding sedatives is because sedatives are known for causing respiratory distress so already this gland is risking airway blockage so we do not want to give sedative as it can go ahead and worsen the situation the other bit is pain management where we want to eliminate this by administering analesics and antibiotics given examples of acettoms and and ibuins to reduce fever and pain and then they can administer cortical steroids to just eliminate the inflammation and reduce any risk of edema that could be happening around the throat oxygen therapy is good because we know with oxygen then we are able to supplement for the hypoxia that is sitting in due to the improper oxygen exchange that is happening but also humidification can help us cool the airway it can eliminate chances of unnecessary bronospins and ensure that the diameters are well dilated to just promote you know airway exchange or airway entry and exit but then like I said this is an emergency case and therefore you need to set up resuscitation equipments to be available on the side just in case this client needs critical intervention due to the assessed status of to the assessed status of respiration so if you detect any risk of distress then it’s good we prepare for endotracchial intubation or you can prepare for trachotomy for the purpose of eliminating severe respiratory distress and uh we’ve seen that part of the causitive agent for epiglotitis is influenza then we need to ensure that the child is also up to date with their immunization schedule specifically influenza conjugates uh sorry the mopillas conjugates so that they are immunized and will we reduce the risk of contacting you know further infections or further influenza related microorganism that can stimulate or keep up uh the inflammation process for the epiglotitis so keeping up that is COVID 19 what we commonly called corona virus so corona virus is an upper respiratory tract infection which is caused by a viral group known as corona vir and the symptoms for corona virus are similar to a syndrome known as s or severe acute respiratory syndrome which happened or occurred in 2003 so it’s known that the reservoir for corona virus is actually among the Chinese horse uh horse hoats which are known to be the natural reservoir for corona viruses so when it comes to incubation period that is between the exposure and to the starting of symptoms it can start immediately after 2 days all the way to 5 days and to just remind us is that corona virus or covid-19 was actually declared a pandemic in the year 2020 and uh it took a lot of intervention and measures to just contain and prevent transmission of this disease so ways of spreading corona virus are highlighted that this is particularly airborne however close contact to a person who has been exposed or infected can increase chances of transmitting this disease so ways of spreading corona virus are reported to be close personto person contact through activities like hugging and kissing but also direct contact with the respiratory secretions and body fluids increases the chances of spreading corona cough and sneezing are one of the most known ways of spreading corona virus now that it’s airborne but also touching infected and contaminated surfaces seem to also increase the chances of contacting corona virus non symptoms or what we referring to as clinical manifestation so there’s the report of fever so the gland can report episodes of fever reporting more than 38° however in some adults they can present as a a fibbril the beginning part of the illness and then as it progresses the temperature can start to become observable or can be measured malaysian fever sorry Malaysian fatigue or general body weakness is also highly observable or present and you can have neurologic symptoms for instance headache so in headache the those who complained that when they were experiencing headache they also tended to have memory loss or they seemed to struggle with reasoning and comprehending comprehending concepts so neurological effects came with several other symptoms apart from just headache then there’s muscle and body ache or general body pain which was also present in some client there’s also dizziness cough was present that was like a cardinal symptom we got shortness of breath or dism running nose and congestion in other client there was presence of diarrhea nausea and vomiting but also we could detect change in sense of smell and tasting so brain fog this is where I was mentioning on about neurological symptoms so it could be brains fog where some will report that they have difficulty in thinking or they are not able to focus properly so if you look at the common symptoms this is where we were mentioning here that common of the symptoms here is this is what you can immediately see in the first two up to 5 days however there are those that seems to come up later in severe cases so by the lighted fever loss of appetite fatigue um alteration of smell shortness of breath coughing muscle aches and pain however in severe cases the client now can have other difficulties you know like difficulty in waking up or confusion bluish face of lips that is now like leading to cyanosis coughing up of blood persistent chest pain decrease in white blood cell levels and then we have kidney failure and extremely high fever so this observable in the severe cases so when you look at corona virus or covid-19 what was more observable is the common symptoms but if you were very keen you found that when it was leading to complications you will actually start detecting most of the severe symptoms that will come up so when it comes to diagnosis to determine whether the patient is a positive covid-19 case then there was ability to do PCRs which means polymerase chain reaction test so this is an antibbody check which will help us detect the antibodies that are highly produced when a plant has covid-19 and so we could do PCR to determine that but then we have the rapid antigen test which are also very good because you can self test these were like self test checks through the swab and you could determine the the status of the client so there are different approaches that were done but there are those who could also do symptomatic analysis and they symptotomatic analysis sorry and they could just confirm if they covid case or not so risk factors for COVID 19 we could have age so advanced age was seen as one of a risk factor that could indicate high risk of contacting COVID 19 and the age of above 65 years was among the risk yes because we explained that the higher the age the lower the immune ability or the immunity and so because of this the client will be more highly exposed to contacting infection compared to younger ages like youth or basically middle-aged then we have pregnant mothers or pregnant women so pregnancy also has an impact on the body because of the physiological changes that come with pregnancy partly the immunity also gets to be compromised and so chances of getting infected are also high history of smoking and generally population that is imunino compromised like client who are cancer diagnosis or cancer diagnosed tended to be more at risk of contacting covid-19 then clients who had positive blood disorders for instance cle cell illnesses these are diseases that are known for lowering immunity too and they tend to increase the chances of contacting corona virus and then we got congenital illnesses such as down syndrome and Libral pulses also were included as a risk factor for contacting corona virus so on the management we were explained that the interventions we will give for the management of corona virus were supportive and they were guided again by symptoms so can talk about symptotomatic supportive management for corona virus so one thing that was like critical when it comes to intervening was administration of oxygen because you could see that this is an inflammatory illness it’s an infection but then oxygen becomes critical cuz you want to salvage and avoid development of respiratory distress among the client then we’ve got corticosteroids which are known for lowering inflammation stats among the respiratory tissues and thus were one of the recommended management vaccination so covid-19 vaccines were critical when it came to handling the covid-19 spread so the brand of COVID 19 vaccines were quite many and so it was advised that you can use any but then discuss that with your doctor and get to agree which one is efficient for each individual so there were examples or we have example like Astroenica and Astroenica was like the most common so Astroenica is good but then you have other options of vaccinations against COVID 19 that you can have so the best management was control measures to just prevent the spread of COVID 19 and part of it was isolation of patients so any contacted client or client were known to have been exposed were taken through isolation to just prevent spread of the illnesses they were also quarantined for any patient who was exposed we don’t have then we have um travel restriction that is um both local and international travels this was to just ensure that we don’t have a lot of people moving from one region to another which is seen as a risk factor of spreading this virus because if you move from one part to another it’s airborne so we tend to breathe in and out and this virus ends to exist in our in our environment then for healthare workers there’s need to use personal protective equipment to just be safe protect oneself and to ensure that we don’t get exposed to contaminated surfaces or fluids hand hygiene was important especially after touching surfaces or being in the exposure for so long then hand washing with soap and water was very important but in some cases where water is limited then you can opt to just do sanitization that is getting sanitizer applying on the hand and using the social technique to just apply and to make sure that you’re protected then there’s avoiding of congestion and keeping social distance more than 1 m is important this is because keeping social distance makes makes sure that you prevent any occurrence of congestion and therefore there’s no there’s no contact or there’s no direct body to body contact that can easily risk us from inhaling the virus then covering of our mouth and nose in cases of sneezing repeating this is an airborne disease so it can easily spread via airborne and because of this when we cover our mouth and nose when we sneeze we reduce the trajectory of how far the virus can be sneezed out so if we cover then we limit it to just within our locality our region where we are standing or seated so this hygiene was to ensure that we avoid spitting or spreading it or splashing it on as many surfaces as possible on the complication bit corona virus is known to to complicate into what we call acute respiratory dis distress or RDS so this is a state whereby the lungs are working poorly or they’re not able to sustain their physiological function of exchanging gases or properly balancing the oxygenation and the exist exit of carbon dioxide into the environment so in this case the plant tended to go through severe hypoxia or the plant need some of them will complicate into respiratory failures and they’ll end up into high density units or acute or critical care units and in this case unfortunately for particular some of them will die so the complication that you’re talking about is acute respiratory distress thank you for keeping up to the end reminder please like the videos if it’s really good give us a comment share in your with your colleagues but also don’t forget to subscribe thank you for staying with me all the way to the end until we meet again in the next class bye-bye
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Epiglottitis- Inflammation of the epiglottis
COVID-19- Infection of upper respiratory tract caused by coronaviridae
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