Peritonsillar abscess

For severe infections indicating Ludwig’s angina do not give anaesthesia or try sedate patient until the airway is secured under local anaesthesia (topical). Even after treatment (incision) remember that the patient can develop laryngeal oedema. In peritonsillar abscess. In case of a child, keep the child in steep Trendelenburg position; keep the mouth open as much as child can open and put a mouth gag for safety. If possible apply a swab soaked in 4% Xylocaine to the area. Take a very thick aspiration needle attached to a suction tube and put it in the abscess cavity. Aspirate all the pus and enlarge the opening with a curved knife. Never give in to any sympathy for a howling child. Never think of giving anaesthesia or even sedation. In extreme circumstances these children breath with accessory muscles of breathing. Any anaesthesia even simple nitrous oxide, oxygen or sedation results in apnoea which can be fatal.