Which of the following should the neonatal/pediatric specialist recommend prior to endotracheal intubation of a 12-year-old child?

• A. edrophonium
• B. Flumazenil
• C. naloxone
• D. succinylcholine

Answer: (D)

Rapid sequence intubation in children relies on a muscle relaxant that acts quickly and wears off relatively fast, providing optimal conditions for tube placement while minimizing apnea time if intubation is difficult. Succinylcholine fits this need with a very fast onset and a short duration of action, making it the best choice for facilitating intubation in a 12-year-old when there are no contraindications.

Edrophonium is used to diagnose or reverse certain neuromuscular issues; it does not produce the rapid, reliable paralysis needed for intubation. Flumazenil reverses benzodiazepines and naloxone reverses opioids, neither of which provides the immediate muscle relaxation required to secure a airway quickly.