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Peritonsillar Abscess (Quinsy). Dr P.T.Kenny. Warning……. A peritonsillar abscess can be drained in primary care but the following patients should be referred: Children. Severely ill. Difficulty breathing. Bilateral abscesses.
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Peritonsillar Abscess (Quinsy) Dr P.T.Kenny.
Warning…… A peritonsillar abscess can be drained in primary care but the following patients should be referred: • Children. • Severely ill. • Difficulty breathing. • Bilateral abscesses. • A large abscess that obstructs the pharynx or may extend posteriorly. • Unsuccessful drainage in primary care. Some patients may require IV fluids for hydration and / or analgesia prior to the procedure.
Equipment needed…. • Headlamp. • 10% topical lignocaine. • Tongue depressor. • Wall suction. • IV line and fluids if necessary. • For aspiration: • 16G IV needle and 5 -10ml syringe for aspiration. • For incision: • No 11 scalpel blade. • Angulated forceps.
Aspiration technique………… • The patient should sit with the head resting back against a headrest. • The mouth is opened with a tongue depressor. • The mucosa over the abscess is sprayed with topical anaesthetic. • Try to localise the pus. • Insert a large needle and aspirate the pus. • Review the next day and if necessary repeat the aspiration.