A 3-year-old unimmunized child presents with acute onset of high fever, toxic appearance, muffled 'hot potato' voice, drooling, and sitting forward in the 'tripod position' with neck extended. Stridor is audible. What is the mandatory immediate management protocol?

Answer and explanation

Correct answer: D. Secure the airway endotracheally in an operating theatre with ENT surgery on standby

  1. Step 1: Acute epiglottitis (typically caused by Haemophilus influenzae type b in unimmunized children) is a critical airway emergency.
  2. Step 2: Any agitation or oral examination with a tongue depressor can precipitate complete laryngospasm; airway securing in a controlled operating suite must take precedence.
Answer
Secure the airway endotracheally in an operating theatre with ENT surgery on standby.
Why not the others: 'Perform an immediate direct tongue-blade oral examination in triage' is strictly contraindicated as it can provoke fatal reflex laryngospasm; 'Force the child into supine position for urgent chest CT scan' will compromise the airway; 'Administer oral amoxicillin and discharge with follow-up' is lethal negligence.

Practise more Pediatric Medicine and Neonatology.

Free questions with an explanation for every one, and full timed National Health Regulatory Authority Licensure Examination (NHRA Bahrain) mock tests.

All Pediatric Medicine and Neonatology questionsTake a mock test

More Pediatric Medicine and Neonatology questions