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Epiglottitis airway management — FRCA Final MCQ

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HardPaediatricEpiglottitis airway managementFRCA Final

A 3-year-old with suspected epiglottitis arrives in theatre sitting forward, drooling and quiet. SpO2 is 95% on oxygen held near the face. Intravenous access has not been obtained and the child becomes distressed when approached. What is the most appropriate anaesthetic technique?

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Correct answer: C — Inhalational induction in theatre with ENT ready for surgical airway

A child with epiglottitis may obstruct completely if distressed; airway management should occur in theatre with senior anaesthetic and ENT support, maintaining spontaneous ventilation during inhalational induction. Forcing cannulation or throat examination can precipitate obstruction. Sedation outside a controlled environment is dangerous. The priority is calm, coordinated airway control with surgical backup.

Reference: APLS guidance; RCoA GPAS paediatric anaesthesia 2022