When providing airway management for a child, which of the following is the correct technique?

• A. Use a tongue blade to depress the tongue
• B. Insert before opening the mouth
• C. Insert with the curved end facing the nasal cavity
• D. Tilt the head back sharply

Answer: (A)

In pediatric airway management, the goal is to keep the tongue from masking the airway and to expose the oropharynx for a clear view. Using a tongue blade to depress the tongue accomplishes this by lifting the tongue away from the airway opening, which helps you see the larynx or place an airway device more safely and effectively. This step is done after you have opened the mouth, so you have space to work and can visualize the structures without forcing anything into a closed space.

Inserting a device before opening the mouth is unsafe and impractical, since there’s no room to properly place or maneuver tools. The tongue blade isn’t used with the curved end toward the nasal cavity; its purpose is simple tongue depression to improve exposure, not navigation toward the nasal passages. Finally, tilting the head back sharply is discouraged in children because excessive extension can worsen airway obstruction and, depending on the scenario, may risk cervical spine injury; a neutral or gently extended “sniffing” position is preferred to optimize airway alignment safely.