Description
A 50 year old man arrives in casualty complaining of a sore throat and dysphagia. He is previously fit and well. Clinical observations are normal. Flexible laryngoscopy notes a swollen larynx with a significantly reduced glottic aperture and a presumptive diagnosis of acute epiglottitis is made. Shortly following this he develops difficulty breathing. Within 30 minutes he is unconscious with a completely obstructed airway, and an emergency tracheostomy is performed. Post tracheostomy he has a tachycardia of 120 and a BP of 130/60. His 12 lead ECG is normal. There is no evidence of soiling of the pharynx with gastric contents on laryngoscopy and a bronchoscopy shows frothy sputum. Arterial blood gases (figure 1) and a CXR (figure 1) are performed immediately following the tracheostomy.
