A 2 year-old presents with sudden onset of cough and stridor. What is the next step in the evaluation of this patient?

In the context of a 2-year-old presenting with sudden onset of cough and stridor, the appropriate next step in evaluation is to obtain a lateral soft tissue x-ray of the neck. This imaging study is particularly useful in assessing for potential causes of stridor, such as croup or foreign body obstruction. Stridor indicates partial obstruction of the upper airway, and the lateral neck x-ray can help visualize the airway structures and identify issues such as significant soft tissue swelling, which is often seen in croup or epiglottitis.

This imaging technique can provide immediate information about the airway, enabling clinicians to make timely decisions regarding management. It is critical to rule out obstructive processes and evaluate the anatomical features that may be contributing to the patient's symptoms before proceeding to more invasive interventions or treatments.

Other options, while they may be part of a broader diagnostic approach in certain contexts, are not the immediate next step when confronted with a young child exhibiting these symptoms. For example, indirect laryngoscopy is more invasive and typically reserved for situations where visual examination of the larynx is necessary, such as suspected vocal cord lesions. Finger sweeps could be applicable if there’s a known aspiration event, but they carry risks and are not a standard diagnostic step