Adult Patients With Peritonsillar Abscess: What Nurse Practitioners in Primary Care Need to Know

A peritonsillar abscess (PTA) is the most common deep neck space infection. Surprisingly, there are no clinical practice guidelines to guide nurse practitioners (NPs) caring for patients with a PTA. This risks inconsistencies in practice and the potential for poor patient outcomes. The purpose of th...

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Veröffentlicht in:Journal for nurse practitioners 2021-02, Vol.17 (2), p.202-208
Hauptverfasser: Tiefel, Nicole L., Lorenz, Mark, Bartlett, T. Robin
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description A peritonsillar abscess (PTA) is the most common deep neck space infection. Surprisingly, there are no clinical practice guidelines to guide nurse practitioners (NPs) caring for patients with a PTA. This risks inconsistencies in practice and the potential for poor patient outcomes. The purpose of this article is to equip NPs with information to accurately diagnose and appropriately manage patients with a PTA. This article describes the most common characteristics of the patient who presents to outpatient providers with unilateral throat pain consistent with a diagnosis of PTA. Accurate diagnosis improves patient safety and prevents inadequate care by implementing research-based management. As part of a quality improvement project, a retrospective analysis was performed on medical record data of 100 patients aged 19 to 59 diagnosed with PTAs at a private outpatient otolaryngology practice. The data were analyzed to look at the most common characteristics of PTA. Findings demonstrated that patients with PTA experienced difficulty controlling oral secretions, where patients with phlegmon did not. A larger number of patients with PTA also experienced lymphadenopathy. Intervening early with accurate diagnosis and initiation of antibiotics and steroids is essential in the treatment of PTA. When symptoms suggest surgical intervention, the NP should promptly refer the patient to otolaryngology to improve outcomes. Close monitoring of the patient with a PTA improves patient safety by decreasing the likelihood of further airway obstruction and to ensure symptoms continue to improve. •There are no clinical practice guidelines for patients with peritonsillar abscess (PTA).•The lack of standardized treatment recommendations leads to inconsistent care and potentially negative patient outcomes.•Patients with PTA may present with airway compromise or upper airway obstruction due to increased oral secretions and more lymphadenopathy.•Patients presenting with suspected PTA should be promptly started on antibiotics and steroids to prevent or lessen complications.•Patients with a PTA should be urgently referred to otolaryngology for surgical management.
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As part of a quality improvement project, a retrospective analysis was performed on medical record data of 100 patients aged 19 to 59 diagnosed with PTAs at a private outpatient otolaryngology practice. The data were analyzed to look at the most common characteristics of PTA. Findings demonstrated that patients with PTA experienced difficulty controlling oral secretions, where patients with phlegmon did not. A larger number of patients with PTA also experienced lymphadenopathy. Intervening early with accurate diagnosis and initiation of antibiotics and steroids is essential in the treatment of PTA. When symptoms suggest surgical intervention, the NP should promptly refer the patient to otolaryngology to improve outcomes. Close monitoring of the patient with a PTA improves patient safety by decreasing the likelihood of further airway obstruction and to ensure symptoms continue to improve. •There are no clinical practice guidelines for patients with peritonsillar abscess (PTA).•The lack of standardized treatment recommendations leads to inconsistent care and potentially negative patient outcomes.•Patients with PTA may present with airway compromise or upper airway obstruction due to increased oral secretions and more lymphadenopathy.•Patients presenting with suspected PTA should be promptly started on antibiotics and steroids to prevent or lessen complications.•Patients with a PTA should be urgently referred to otolaryngology for surgical management.</description><identifier>ISSN: 1555-4155</identifier><identifier>EISSN: 1878-058X</identifier><identifier>DOI: 10.1016/j.nurpra.2020.09.007</identifier><language>eng</language><publisher>Philadelphia: Elsevier Inc</publisher><subject>Abscesses ; Age ; Airway management ; Antibiotics ; Cellulitis ; Clinical medicine ; Clinical outcomes ; Clinical practice guidelines ; management ; Medical diagnosis ; Medical records ; Nurse practitioners ; Obstruction ; Otolaryngology ; Pain ; Patient safety ; Pediatrics ; peritonsillar abscess ; phlegmon ; Primary care ; Quality management ; Steroids ; Symptoms ; Throat surgery ; Tonsillitis ; unilateral throat pain</subject><ispartof>Journal for nurse practitioners, 2021-02, Vol.17 (2), p.202-208</ispartof><rights>2020 Elsevier Inc.</rights><rights>2020. 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subjects Abscesses
Age
Airway management
Antibiotics
Cellulitis
Clinical medicine
Clinical outcomes
Clinical practice guidelines
management
Medical diagnosis
Medical records
Nurse practitioners
Obstruction
Otolaryngology
Pain
Patient safety
Pediatrics
peritonsillar abscess
phlegmon
Primary care
Quality management
Steroids
Symptoms
Throat surgery
Tonsillitis
unilateral throat pain
title Adult Patients With Peritonsillar Abscess: What Nurse Practitioners in Primary Care Need to Know
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