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Sir.—I have always believed that one of the worst suggestions ever given to the private practitioner was that of diagnosing epiglottitis by a lateral neck film. Probably the worst place to take a patient with epiglottitis would be down a long hall to the radiology department, with all the associated trauma, fear, and suspense.
For 25 years I have looked, in the office, for epiglottitis, usually just with a tongue depressor and penlight and occasionally with a laryngoscope. The epiglottis is usually easily visible and the diagnosis is rapidly made or ruled out, at no expense and with no emotional trauma. Carefully done, there is little gagging and no more distress than the patient has already experienced.
ROBINS MM. Oropharyngeal Examination for Suspected Epiglottitis. Am J Dis Child. 1988;142(12):1265. doi:10.1001/archpedi.1988.02150120019015