Which action is NOT recommended for a pediatric patient with suspected epiglottitis?

• A. Place patient in sitting position
• B. Do not visualize the oropharynx
• C. Calm the patient with gentle reassurance
• D. Visualize the oropharynx to suction secretions

Answer: (D)

In suspected pediatric epiglottitis, the priority is to minimize stimulation of the airway. The swollen epiglottis can obstruct the airway abruptly, and touching or visually inspecting the throat can provoke coughing, gagging, or laryngospasm, potentially making the airway collapse. Because of that, direct visualization of the oropharynx to suction secretions is not recommended.

Keeping the child calm and seated helps reduce distress and work of breathing, and providing comfortable, noninvasive oxygen support while arranging rapid transport to a facility capable of definitive airway management are the appropriate steps. If suctioning is absolutely necessary, it should be done with as little airway stimulation as possible and by professionals who can manage a potential airway emergency.