In suspected epiglottitis, which diagnostic maneuver should be avoided to minimize airway risk?

• A. Laryngoscopy
• B. Blood testing
• C. Lateral neck X-ray
• D. Pulse oximetry

Answer: (A)

When epiglottitis is suspected, any attempt to manipulate the airway can provoke a dangerous airway collapse. Laryngoscopy directly visualizes or touches the epiglottis, and this irritation can trigger laryngospasm or sudden obstruction in an inflamed airway. Because of this, avoid laryngoscopy in the acute setting unless a secure airway is already established and the procedure is planned in a controlled environment with experienced personnel. Safer steps include imaging with a lateral neck X-ray to look for the thumbprint sign, and continuous noninvasive monitoring such as pulse oximetry to assess oxygenation. Blood tests may be obtained as part of evaluation but do not diagnose epiglottitis and do not pose the same airway risk. If airway compromise develops, secure the airway in a controlled setting.