Sir.—I expect (and hope) that the report by Mauro et al1 will not change the traditional approach of avoiding the office oropharyngeal examination of the child with suspected epiglottitis. Anecdotal or not, many pediatricians have seen (or know someone who has seen) a child with epiglottitis who had laryngospasm as a result of a tongue blade examination. I might risk venturing into waters where a shark lurks were I provided with a shark cage and an expert with a speargun; similarly, I might attempt an emergency department examination for suspected epiglottitis with an experienced intubator present. It does not seem that Mauro et al are suggesting we do otherwise.
FISCHER H. Oropharyngeal Examination for Suspected Epiglottitis. Am J Dis Child. 1988;142(12):1261. doi:10.1001/archpedi.1988.02150120015001