During diazepam overdose management in a child, which action should be performed immediately to secure the airway?

• A. Insert an orogastric tube for gastric lavage.
• B. Prepare a set-up for endotracheal intubation.
• C. Draw blood for stat chemistries and blood gases.
• D. Place a Foley catheter to monitor renal functioning.

Answer: (B)

In a diazepam overdose, the immediate danger is loss of consciousness with respiratory depression and potential airway obstruction. The first priority is to protect and secure the airway so the child can be adequately ventilated. Preparing for endotracheal intubation provides a definitive airway, allowing controlled ventilation and reducing the risk of aspiration as the central nervous system impact from the overdose evolves. This is why arranging for intubation setup and readiness to proceed is the best initial action.

While other steps like gastric lavage, obtaining labs, or catheterization have their places in broader management, they do not address the life-threatening airway risk present in this scenario.