What is the recommended management for severe or marked stridor?

What is the recommended management for severe or marked stridor?

• A. Humidified air
• B. Intubate using one size smaller endotracheal tube
• C. Nebulized albuterol
• D. Observation only

Answer: (B)

Severe or marked stridor means significant upper airway narrowing that can rapidly worsen, so securing the airway becomes the immediate priority. Intubating the patient provides a definitive airway and ventilation pathway, effectively bypassing the obstructed segment caused by edema or swelling. Using a smaller-diameter endotracheal tube helps accommodate the edematous airway, making advancement of the tube more feasible and reducing the risk of trauma or post-intubation swelling that could worsen obstruction. Humidified air or observation alone won’t relieve the obstruction or prevent potential respiratory failure, and nebulized albuterol mainly helps lower airway bronchodilation rather than addressing upper airway edema. For this level of severity, airway protection with intubation using a smaller tube is the most appropriate management.

Severe or marked stridor means significant upper airway narrowing that can rapidly worsen, so securing the airway becomes the immediate priority. Intubating the patient provides a definitive airway and ventilation pathway, effectively bypassing the obstructed segment caused by edema or swelling. Using a smaller-diameter endotracheal tube helps accommodate the edematous airway, making advancement of the tube more feasible and reducing the risk of trauma or post-intubation swelling that could worsen obstruction. Humidified air or observation alone won’t relieve the obstruction or prevent potential respiratory failure, and nebulized albuterol mainly helps lower airway bronchodilation rather than addressing upper airway edema. For this level of severity, airway protection with intubation using a smaller tube is the most appropriate management.