Sir.—On the issue of acute supraglottitis, I vote with Mauro et al. As a physician-educator, I have maintained appointments in family medicine and emergency medicine during the past ten years. The avoidance of traumatic or forceful manipulation is a fact of life. Lateral soft-tissue roentgenograms of the neck have been overrated, even though every lecturer shows one slide of a grossly deformed epiglottis. By the time I see these children, in literally every case the tongue has been depressed (ie, step 2 of Mauro and colleagues' protocol). Anecdotally, there have been no known complications during the past ten years.