child with respiration difficulty - kallastro

[ArchivalUser]

A 3-year-old boy develops fever and noisy breathing. In the ED, he is irritable, anxious, and has stridor and drooling. He does not want to lie down. His mother reports up-to-date immunizations. What is the most appropriate next step in this patient™s management?

1. Immediate administration of intravenous antibiotics
2. Immediately visualize the epiglottis to confirm epiglottitis
3. Keep the child in a position of comfort pending endotracheal intubation
4. Obtain complete blood count and blood culture

[ArchivalUser]

1. as, 2,3 is fatal in epiglottitis. 4 would be too indolent a respose

[ArchivalUser]

1 or 3?3

[ArchivalUser]

1. or 1

[ArchivalUser]

3, (actually I'd have said give a trial of racemic epinephrine and humidified O2, and if that fails, go for intubation in OR)

[ArchivalUser]

tricky question..... 3 is da answer. First thing to do is secure an airway, then blood culture and antibiotics. placing patient in a position of comfort is actually subjective...the patient determines whats comfy..