1. Peritonsillar Abscess (Quinsy)
Dr P.T.Kenny.

2. 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.

3. 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.

5. 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.

8. Where to aspirate / incise.