Irish Journal of Medical Science

, Volume 173, Issue 4, pp 197–199 | Cite as

Airway intervention in adult supraglottitis

  • D Madhotra
  • JE Fenton
  • ZGG Makura
  • P Charters
  • NJ Roland
Original Paper


Background The timing of aggressive airway intervention in adult epiglottitis is controversial.

Aims To correlate Friedman’s staging of epiglottitis on admission with the airway interventions undertaken.

Methods A retrospective study of 23 adult patients, mean age 51 years (range 29–81 years), who had been admitted with acute supraglottitis between March 1988 and December 2000 was undertaken.

Results Three patients (13%) had airway interventions; two with tracheostomy and one with tracheal intubation. All were Friedman stage III and had rapid symptom progression during the 24 hours prior to admission. Three other stage III patients with symptom progression longer than 24 hours and all the remaining patients (stage II or less) were managed with observation and intravenous therapy.

Conclusions Friedman originally advocated airway intervention in any patient stage II or worse, but this intubation threshold should probably be lowered to those patients with rapid-onset stage III (moderate respiratory distress, stridor, respiratory rate >30 per minute, pCO2 >45mmHg) disease.


Throat Swab Epiglottitis Airway Intervention Acute Epiglottitis Fibreoptic Laryngoscopy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer London 2004

Authors and Affiliations

  • D Madhotra
    • 1
  • JE Fenton
    • 1
  • ZGG Makura
    • 1
  • P Charters
    • 2
  • NJ Roland
    • 1
  1. 1.Department of Otolaryngology, Head and Neck SurgeryUniversity Hospital AintreeLiverpoolUK
  2. 2.Department of AnaesthesiaUniversity Hospital AintreeLiverpoolUK

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