Head and Neck Q1

A 72-year-old man presents to the emergency department with recent onset of sore throat, difficulty swallowing and pain on swallowing. From the bedside, you hear a loud, harsh, high-pitched respiratory sound on inspiration. His respiratory rate is 26 and his oxygen saturation is 95% on air. He is started on high-flow oxygen. His respiratory rate and his oxygen saturation remain unchanged. On brief examination, the oropharynx appears unremarkable. There is anterior neck tenderness, especially over the hyoid bone. 

What is the best next step in the management of this patient?

  • A) Admit and transfer the patient to a respiratory ward for observation
  • B) Give nebulised adrenaline and IV dexamethasone
  • C) CT chest and neck immediately
  • D) Intubate
  • E) Emergency tracheostomy