A child is brought to the emergency department with a respiratory infection. The child is struggling to breath and is very anxious. The health care providers suspect epiglottitis. Which of the following interventions would be a priority?
A) Have parents help hold the child down so blood work can be drawn and sent to lab so WBC count can be reviewed.
B) Try to get the child to open his mouth so you can put a tongue blade in the back of the throat to look for swelling or pustules.
C) Place the child upright in bed and begin preparing for a tracheostomy placement.
D) Administer the first dose of an antibiotic vial liquid suspension as soon as possible to begin fighting the infection.
Ans: C
Feedback:
Epiglottitis is a medical emergency, and immediate establishment of an airway by endotracheal tube or tracheostomy is usually needed. If epiglottitis is suspected, the child should never be forced to lie down because this causes the epiglottis to fall backward and may lead to complete airway obstruction. Examination of the throat with a tongue blade may cause airway spasm and cardiopulmonary arrest and should be done only by medical personnel experienced in intubation of small children. It also is unwise to attempt any procedure, such as drawing blood, which would heighten the child's anxiety because this also could precipitate airway spasm and cause death.
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