A 2-year-old boy is in severe respiratory distress. The child is drooling and has labored breathing. Stridor is heard. RR is 42 breaths/min and HR is 148 beats/min. What should be done next?
a. Intubate.
b. Provide 100% oxygen on nonrebreather mask.
c. Administer racemic epinephrine.
d. Place on CPAP with low PSV.
ANS: A
The clinical picture, particularly the age, level of distress, stridor, and drooling, suggests that this patient apparently has epiglottitis, a severe swelling of the tissue around the glottis. Given the potential for additional swelling and complete airway closure, this patient should be intubated for airway protection.
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