Your patient is a five-year-old girl who awoke with a harsh cough, sore throat, drooling, and high fever. She has shallow respirations of 40 and inspiratory stridor. She is completely focused on breathing, leaning forward on her outstretched arms. Which of the following is the best course of action?
A) Start an IV for administration of succinylcholine and midazolam for RSI, intubate the trachea, and ventilate at a rate of 24 to 28 per minute.
B) Provide high-concentration oxygen by nonrebreather mask, start an IV, and repeat a full set of vital signs every 5 minutes en route to the emergency department.
C) Inspect the hypopharynx for edema and be prepared for immediate surgical cricothyrotomy if airway obstruction is imminent.
D) Provide blow-by oxygen, humidified if possible; transport without delay and avoid procedures that might upset her.
D
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