NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationMedium
A 5-year-old child presents with a sudden onset of respiratory distress. On examination, you note inspiratory stridor, drooling, and a high fever. The child is sitting upright and appears anxious. What is the most appropriate initial intervention?
- AAttempt to visualize the airway with a tongue depressor.
- BPrepare for immediate intubation.
- CAdminister humidified oxygen via nasal cannula.
- DTransport rapidly in a position of comfort.
Show answer & explanationAnswer & explanation
Correct answer: D. Transport rapidly in a position of comfort.
The symptoms described (stridor, drooling, high fever, anxious appearance, sitting upright) are classic for epiglottitis. Any attempt to visualize the airway or force a supine position could worsen airway obstruction. Rapid transport in a position of comfort is crucial.
Why the other options are wrong
- A. Attempting to visualize the airway can trigger laryngospasm and complete airway obstruction in a patient with epiglottitis.
- B. Intubation is a definitive airway management technique but should only be performed in a controlled environment by skilled personnel, not as an initial field intervention for a stable epiglottitis patient.
- C. While oxygen is beneficial, it's not the most critical initial intervention and should be done without agitating the child.
Epiglottitis Management
Epiglottitis is a life-threatening inflammation of the epiglottis, often bacterial, causing rapid airway obstruction. Management focuses on minimizing agitation and rapid transport.
- Characterized by sudden onset, high fever, drooling, dysphagia, and inspiratory stridor.
- Patients often prefer an upright, 'sniffing' position.
- Avoid any interventions that could agitate the child or manipulate the airway, as this can lead to complete obstruction.
Memory trick: Don't poke the 'epi' with a stick, just rapidly transport and let them sit.