A 4-year-old male presents with audible stridor, a barking cough, and increased work of breathing. He is conscious and alert; has pink, warm skin; and has a heart rate of 100 beats/min. Further assessment reveals clear and equal lung sounds over all fields, an oxygen saturation of 97%, and a temperature of 99.2°F. You should:
A: give him 10 mg/kg of pediatric acetaminophen, administer high-flow oxygen via nonrebreathing mask, and establish vascular access.
B: administer a 0.5-mg unit dose of ipratropium via nebulizer, give him oxygen as tolerated, and make preparations to perform tracheal intubation.
C: let him assume a position of comfort, offer oxygen via the blow-by technique, and administer a 2.25% solution of racemic epinephrine via nebulizer.
D: avoid agitating him, establish vascular access and set the rate to keep the vein open, and give 2.5 to 5 mg of albuterol via nebulizer up to three times.
Answer: C: let him assume a position of comfort, offer oxygen via the blow-by technique, and administer a 2.25% solution of racemic epinephrine via nebulizer.
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