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Sir.—First, I must comment on a non-medical point. The word epiglottitis is in common parlance; why therefore indulge in the dubious sport of newspeak in writing about something called supraglottitis? This does not serve the purpose of clarity of communication.
Mauro and colleagues have clearly defined some of the issues. The largest issue of all is that the vast majority of acutely stridulous children do not present themselves to emergency departments but rather to the offices of their physicians. Half of these physicians, I would anticipate, are not pediatricians. What are the realistic alternatives? The currently taught dictum of not looking and certainly not touching (no tongue blade) leads to both underdiagnosis and oversuspicion. One result is the risk of epiglottitis progressing to a critical and life-threatening state before being recognized; the other result (and just as serious an issue although not so immediate) is the vast overuse of emergency
GOLDSMITH R. Oropharyngeal Examination for Suspected Epiglottitis. Am J Dis Child. 1988;142(12):1265–1266. doi:10.1001/archpedi.1988.02150120019016
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