A child with sudden onset difficulty breathing and cough raises suspicion for foreign body aspiration. What is the most appropriate next step in management?

Prepare for the NBME Form 10 Step 2 Test. Utilize flashcards and multiple choice questions, with hints and explanations for each. Ace your exam preparation!

Multiple Choice

A child with sudden onset difficulty breathing and cough raises suspicion for foreign body aspiration. What is the most appropriate next step in management?

When a child suddenly develops coughing and difficulty breathing, suspicion for foreign body aspiration is high, and the priority is to visualize and remove the object directly. Bronchoscopy serves both diagnostic and therapeutic roles here, making it the best next step. In children, rigid bronchoscopy under general anesthesia is the standard because it provides secure airway control and allows removal of the obstructing object in one procedure.

Imaging like a chest X-ray can help by showing indirect signs such as unilateral hyperinflation or atelectasis or identifying radiopaque objects, but many aspirated items are radiolucent and X-ray may be normal. Relying on imaging alone can delay definitive treatment. Nebulized albuterol might temporarily relieve bronchospasm but does not address the obstruction and can delay recovery. Antibiotics aren’t indicated unless there’s evidence of infection.

So, urgent bronchoscopy to identify and remove the foreign body is the most appropriate next step.

A child with sudden onset difficulty breathing and cough raises suspicion for foreign body aspiration. What is the most appropriate next step in management?

Prepare for the NBME Form 10 Step 2 Test. Utilize flashcards and multiple choice questions, with hints and explanations for each. Ace your exam preparation!

A child with sudden onset difficulty breathing and cough raises suspicion for foreign body aspiration. What is the most appropriate next step in management?

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