The tongue has an excellent blood supply so often heals well but through and through lacerations generally do require repair.

As a result make sure you sheath your aspiration needle so that only about 1cm can enter the tonsil.

ACE inhibitor angioedema does not respond to adrenaline, steroids and anti histamines---the mainstay of treatment in anaphylaxis.

ACEi angioedema responds differently to Hereditary angioedema but tranexamic acid and FFP is a reasonable and easily available option.

EMcrit does a good review. https://emcrit.org/ibcc/angioedema/#bradykinin_angioedema:_treatment

Unvaccinated children still occasionally get Diphtheria. There were 2 cases in NSW in July 2022.

Michael Douglas developed tongue carcinoma from HPV (Human Papilloma Virus).

The papillae become enlarged and change colour to black, giving the appearance of a black hairy tongue.

Penicillin is still the mainstay of the treatment of proven Strep pharyngitis. Treatment is especially important in the Indigenous population to help decrease acute rheumatic fever. In the NT the incidence of acute rheumatic fever is the highest in the world.

Generally the child's problem is oral pain with refusal to drink. Most of the time it self limits in 10 to 14 days ard only requires supportive treatment with simple oral analgesia and Xylocaine viscus to assist. In immunocompromised patients IV antivirals may be required.

I would suggest gargle 3% Hydrogen Peroxide diluted i in 3 with iced water. Sit the patient up. Bilateral compression of Carotid arteries is a very unwise idea.

This traditional technique usually requires some cautious sedation. Having the patient sitting upright in a bed and a second operator holding the forehead whilst the relocation occurs assists, otherwise the head comes forward with the operator.

Other techniques that require less sedation include the "syringe technique". Here is a link explaining some other techniques.

https://sinaiem.org/foam/4-reduction-techniques-of-anterior-mandible-dislocation/