Choice A rationale:

Tracheostomy may be necessary in severe cases of epiglottitis where the airway obstruction is life-threatening and cannot be managed with other interventions.

In such cases, creating a surgical airway via tracheostomy can provide a more stable and secure airway, ensuring adequate oxygenation.

However, this option is typically considered when other measures, such as intubation, have failed or are not feasible due to the severity of the obstruction.

Choice B rationale:

Intubation may be required in cases where the airway obstruction is significant, and the child is unable to maintain oxygenation and ventilation adequately.

Intubation allows for mechanical ventilation, ensuring a patent airway and adequate oxygen supply.

However, it is not always the only option and may depend on the severity of the condition and the response to other interventions.

Choice C rationale:

Tracheostomy is more invasive than intubation.

While tracheostomy is a surgical procedure that involves creating an opening in the trachea, intubation involves inserting a tube through the mouth or nose into the trachea.

Tracheostomy is considered more invasive because it requires a surgical incision and the placement of a permanent or temporary tracheostomy tube.

Choice D rationale:

Intubation is not always the first choice for airway management in epiglottitis.

The choice of airway management (intubation, tracheostomy, or other interventions) depends on the severity of the airway obstruction, the child's clinical condition, and the healthcare provider's assessment.

Intubation may be chosen if the obstruction is significant and the child cannot maintain adequate oxygenation and ventilation.