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An oropharyngeal airway can relieve upper airway obstructions in an unconscious child without an intact gag reflex. Select size from incisors/centre of the mouth to the angle of the jaw, insert the correct way up under direct vision using a tongue depressor. Incorrect sizing or insertion may worsen obstruction or cause trauma, gagging, vomiting and aspiration risk.
Track-and-trigger scores have reshaped how we recognise deterioration — but the score only tells us when to look, not what we're seeing. Physiological reserve, masked deterioration, and cognitive bias, all remind us that clinical judgement remains our sharpest tool for reading the patient behind the number.
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