A febrile 4-year-old is drooling, sitting forward, has a muffled voice and becomes distressed when examined. There is soft inspiratory stridor. What is the single best next action?
The immediate priority is controlled airway management. Attempted throat examination, separation from a parent or unplanned imaging may precipitate complete obstruction.
A. Keep the child calm and summon an experienced paediatric airway team: The immediate priority is controlled airway management. Attempted throat examination, separation from a parent or unplanned imaging may precipitate complete obstruction.
B. Inspect the pharynx with a tongue depressor: This can precipitate critical obstruction.
C. Send the child alone for lateral neck radiography: Investigation must not delay or separate the child from airway expertise.
D. Give oral fluids to assess swallowing: This increases distress and aspiration risk.
E. Treat as simple croup and discharge: Drooling, tripod posture and toxic appearance are not a routine croup pattern.
If the child had a barking cough, hoarse voice and no drooling or toxicity, croup would become more likely.
Draft Clinora educational material only; not official JCIE content, an accredited programme, or a substitute for local policy and specialist judgement.
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