South Dakota medicine : the journal of the South Dakota State Medical Association
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Review Case Reports
Acute epiglottitis in adults: an under-recognized and life-threatening condition.
Epiglottitis is a potentially life-threatening condition resulting from infection of the epiglottis and surrounding structures, causing classical signs and symptoms related to inflammation and progressive airway obstruction. We briefly present two recent adult cases of epiglottitis, followed by a review of the literature concerning the subject. In diagnosing epiglottitis, direct visualization by laryngoscopy is the gold standard. ⋯ Though prophylactic airway management is not necessarily indicated in the adult with epiglottitis, careful attention to the airway in a controlled intensive care environment is recommended. The severity of the clinical picture should guide the physician in his or her approach. Any clinical suspicion of epiglottitis warrants an aggressive approach until epiglottitis is ruled out or the patient is recovering well.
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Patients with acute or chronic subdural hematomas may present with rapidly deteriorating neurological function and are at risk for irreversible brainstem injury. In such cases, rapid surgical intervention is required to evacuate the hematoma and reverse critically elevated intracranial pressure. ⋯ The SEPS provides for a minimally invasive technique to drain subdural hematomas and is advantageous in that it can be performed at the bedside. The SEPS is relatively simple to use and may be especially useful to emergency department staff in outlying areas where there is a shortage of neurosurgical coverage.