مولود يكح ويزرق مع أول رضعة ويطلع منه لعاب كثير، وتأكد عنده ناسور بين المريء والقصبة الهوائية. ما الإجراء الأولوية قبل العملية؟

A newborn coughs and turns cyanotic with the first feed and drools excessively; a tracheo-oesophageal fistula is confirmed. What is the pre-operative priority?

1. Give glucose water by bottle only
2. Lay the infant completely flat on his back
3. Try small, frequent bottle feeds
4. NPO, continuous suction and head elevated

Answer: D) NPO, continuous suction and head elevated. Aspiration is the main danger: NPO, continuous suction of the oesophageal pouch and head elevation to limit reflux into the lungs.