Author: Duncan Thomas / Editor: Jason Kendall / Reviewer: Chris Wearmouth / Code: RC1, RC4, RP2, SLO5 / Published: 30/10/2020

A 14-month-old boy presented to the Emergency Department (ED) following a choking episode the previous day at kindergarten. He had been eating a piece of diced apple at the time. His mother subsequently noticed a squeaking noise while he was breathing – as if he was quacking, doctor . He was treated by his GP for a wheezing episode using salbutamol and prednisolone. He was referred to the ED since he had not improved after 48 hours of treatment.

On examination, the child was well and in no overt respiratory distress.

There was decreased air entry over the left lung field and fixed, high-pitched noisy respirations audible throughout the chest.