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Sir.—On the issue of acute supraglottitis, I vote with Mauro et al. As a physician-educator, I have maintained appointments in family medicine and emergency medicine during the past ten years. The avoidance of traumatic or forceful manipulation is a fact of life. Lateral soft-tissue roentgenograms of the neck have been overrated, even though every lecturer shows one slide of a grossly deformed epiglottis. By the time I see these children, in literally every case the tongue has been depressed (ie, step 2 of Mauro and colleagues' protocol). Anecdotally, there have been no known complications during the past ten years.
RODNEY WM. Oropharyngeal Examination for Suspected Epiglottitis. Am J Dis Child. 1988;142(12):1265. doi:10.1001/archpedi.1988.02150120019014