A 2-year-old child is brought with sudden onset cough, wheeze, and decreased breath sounds on the right side after playing with peanuts. The next appropriate step after confirming a right-sided inhaled foreign body is:

• A Emergency tracheotomy
• B Back blows and chest thrusts (Heimlich)
• C Flexible bronchoscopy for diagnostic confirmation
• D Rigid bronchoscopy under general anaesthesia ✓

Explanation

A confirmed foreign body in the lower airway of a child is an emergency managed by rigid bronchoscopy under general anaesthesia, which allows both visualisation and extraction with optical forceps. Flexible bronchoscopy is inadequate for safe extraction. Back blows and Heimlich manoeuvre are used for acute total airway obstruction. Tracheotomy is not the primary approach and does not address a bronchial foreign body.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.