A 3-year-old child presents with wheezing after playing with crayons. What procedure should be recommended?

The situation described involves a 3-year-old child who has developed wheezing after playing with crayons. This raises concern for potential airway obstruction or aspiration of a foreign body, particularly since children in this age range often place objects, like crayons, in their mouths.

Rigid bronchoscopy is the preferred procedure in this case because it allows for direct visualization of the airway and the ability to remove any foreign body that may be causing the wheezing. It is particularly effective in children due to its ability to provide both diagnostic information and therapeutic intervention if an obstruction is present.

In contrast, a chest x-ray would only provide indirect information regarding any obstruction or pathology in the lungs, and it would not allow for intervention. Similarly, a lateral neck x-ray typically evaluates for issues such as croup or other upper airway abnormalities, which are not directly relevant here. Flexible bronchoscopy, while useful in certain contexts, is generally not the first choice when a foreign body obstruction is suspected, especially in a pediatric patient, due to concerns over incomplete removal and the potential for trauma in a child’s more delicate airway.

Thus, rigid bronchoscopy stands out as the most appropriate and effective procedure for addressing the wheezing in this scenario.