Trauma: airway in children: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Trauma: airway in children

Sample item

A 7-year-old boy has severe facial trauma with upper airway obstruction. Bag-mask ventilation and two attempts at orotracheal intubation fail, and saturation is falling to 70%. What is the appropriate surgical airway?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Needle cricothyroidotomy with jet insufflation

In a can't intubate, can't oxygenate situation, a surgical airway is required. In children under about 12 years the cricothyroid membrane is small and the cricoid ring is the narrowest, fully circumferential part of the airway, so a surgical incision risks subglottic stenosis. Needle cricothyroidotomy with oxygen insufflation is therefore preferred.

Option by option

  • A. Surgical cricothyroidotomy with a cuffed tube

    Surgical cricothyroidotomy is avoided in young children because of the small membrane and risk of laryngeal injury.

  • B. Elective tracheostomy in the ward

    An elective tracheostomy takes far too long in a child who is desaturating now.

  • C. Needle cricothyroidotomy with jet insufflation (correct)

    Correct. Needle cricothyroidotomy is the recommended emergency airway in younger children.

  • D. Further blind nasal intubation

    Repeated blind attempts delay oxygenation and can worsen facial injuries.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Needle cricothyroidotomy with jet insufflation. In a can't intubate, can't oxygenate situation, a surgical airway is required.

Why is "Surgical cricothyroidotomy with a cuffed tube" not the answer?

Surgical cricothyroidotomy is avoided in young children because of the small membrane and risk of laryngeal injury.

Why is "Elective tracheostomy in the ward" not the answer?

An elective tracheostomy takes far too long in a child who is desaturating now.

Why is "Further blind nasal intubation" not the answer?

Repeated blind attempts delay oxygenation and can worsen facial injuries.

What concept does this question test?

It tests Trauma: airway in children in General Surgery. In children under about 12 years the cricothyroid membrane is small and the cricoid ring is the narrowest, fully circumferential part of the airway, so a surgical incision risks subglottic stenosis. Needle cricothyroidotomy with oxygen insufflation is therefore preferred.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma: airway in children?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.