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Epiglottitis — RACP Paediatrics MCQ

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ModerateRespiratoryEpiglottitisRACP Paediatrics

A 3-year-old child is brought to the emergency department with sudden onset of stridor at rest, drooling, and a toxic appearance. Temperature is 40.2°C. She is sitting upright with her neck extended. What is the most appropriate immediate action?

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Correct answer: B — Keep the child calm and arrange urgent anaesthetic/ENT review for airway management

This presentation is consistent with acute epiglottitis. The child should be kept calm and undisturbed. Urgent senior anaesthetic and ENT involvement is required for controlled intubation, ideally in the operating theatre. Direct laryngoscopy at the bedside, unnecessary investigations, and routine croup management should be avoided as they may precipitate acute airway obstruction.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Upper Airway Obstruction