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Triage and immediate threats
Airway and instability screen
Drooling
Stridor
Muffled voice
Tripod position
Inability to handle secretions
Toxic appearance
Neck swelling
Trismus
Respiratory distress
Hypotension
Time critical actions
Escalation triggers
If drooling or stridor, airway-ready setting
Avoid agitating exam
ENT and anesthesia activation
Prepare for difficult airway
Evidence level: expert consensus (ACEP Level C equivalent)
If unilateral tonsillar swelling with uvular deviation, peritonsillar abscess pathway
Airway risk assessment
Drainage capability check
If neck stiffness and bulging posterior pharynx, deep neck space infection pathway
CT neck with IV contrast planning
Early ENT involvement
If systemic toxicity or dehydration, IV access and fluid resuscitation
Crystalloid bolus 10 to 20 ml/kg
Reassessment after bolus
Initial isolation and public health flags
Infection control considerations
Suspected diphtheria
Droplet precautions
Public health notification
Antitoxin access planning
Suspected meningococcal disease
Droplet precautions
Empiric sepsis pathway
Key concepts
Working diagnosis framing
Viral pharyngitis most common etiology
Supportive care default when viral features dominant
Group A Streptococcus pharyngitis
Treatment to prevent acute rheumatic fever
Testing guided by pretest probability scores
Complications
Peritonsillar abscess
Retropharyngeal abscess
Epiglottitis
Lemierre syndrome
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.