A toddler presents in the ED with muffled voice, drooling, chin thrust forward, and inspiratory stridor with fever. Which action should the nurse take first?

A toddler presents in the ED with muffled voice, drooling, chin thrust forward, and inspiratory stridor with fever. Which action should the nurse take first?

• A. Inspect the throat with a tongue depressor
• B. Encourage the child to lie flat
• C. Prepare for immediate endotracheal intubation and avoid throat examination
• D. Administer a sedative to calm the child

Answer: (C)

This presentation signals epiglottitis, a sudden risk of life-threatening airway obstruction. The priority is to secure the airway in a controlled setting. Preparing for immediate endotracheal intubation ensures the airway is protected if swelling progresses, and avoiding any throat examination is crucial because manipulating the swollen epiglottis can trigger laryngospasm and worsen obstruction. Keep the child in a calm, upright position and provide oxygen as needed while the airway team is assembled. Sedatives or trying to look at the throat can derail airway management and are not appropriate before securing the airway.

This presentation signals epiglottitis, a sudden risk of life-threatening airway obstruction. The priority is to secure the airway in a controlled setting. Preparing for immediate endotracheal intubation ensures the airway is protected if swelling progresses, and avoiding any throat examination is crucial because manipulating the swollen epiglottis can trigger laryngospasm and worsen obstruction. Keep the child in a calm, upright position and provide oxygen as needed while the airway team is assembled. Sedatives or trying to look at the throat can derail airway management and are not appropriate before securing the airway.