After ventilating a newly born infant by bag-valve-mask device, you note significant gastric distention that is beginning to interfere with ventilation. On attempting to pass a nasogastric tube to decompress the stomach, you find that there is an obstruction bilaterally at the level of the posterior nasopharynx. Which of the following choices indicates the likely problem and the action that
should be taken?
A) Choanal atresia; rotate the nasogastric tube back and forth between your fingers as you apply steady pressure in a posterior direction
B) Cleft palate; rotate the nasogastric tube back and forth between your fingers as you apply steady pressure in a posterior direction
C) Cleft palate; intubate the trachea and pass an orogastric tube
D) Choanal atresia; intubate the trachea and pass an orogastric tube
D
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