A choking toddler with sudden onset unilateral wheeze most strongly suggests the need for which procedure?

• A. Rigid bronchoscopy.
• B. Flexible bronchoscopy.
• C. Laryngoscopy.
• D. Chest tube placement.

Answer: (A)

A choking toddler with sudden unilateral wheeze strongly suggests a foreign body obstructing one airway. In young children, removing a suspected airway foreign body is best done with rigid bronchoscopy because it provides a secure airway and ventilation throughout the procedure, and it allows the use of larger, more robust instruments to grasp and retrieve the object. The rigid scope also offers excellent airway control and suctioning, which is crucial if secretions or bleeding are present during extraction, and it tends to be more effective for a variety of object types in the pediatric airway.

Flexible bronchoscopy can be helpful in older children or for diagnostic purposes or certain situations, but it offers less airway security and a smaller instrument channel, making urgent foreign-body removal in toddlers more challenging. Laryngoscopy only examines the larynx and wouldn’t reach a foreign body in the trachea or main bronchi. Chest tube placement is unrelated to foreign body retrieval and would be used for conditions like pneumothorax or pleural effusion, not removal of an airway object.