A 4-year-old child came post URTI 2 days ago complaining of shortness of breath and wheezing, with respiratory rate 33, heart rate 100, and oxygen saturation 82%. Parents reported... A 4-year-old child came post URTI 2 days ago complaining of shortness of breath and wheezing, with respiratory rate 33, heart rate 100, and oxygen saturation 82%. Parents reported multiple previous hospitalizations for the same issue. What is the management? A. ABx and systemic steroid B. IV fluid and ventolin C. Ventolin and systemic steroid D. ABx with nebulizer ventolin
Understand the Problem
The question is describing a medical scenario involving a 4-year-old child with signs of respiratory distress after a recent upper respiratory tract infection (URTI). It asks for the appropriate management option among four provided choices, which suggest treatments related to asthma or wheezing.
Answer
Ventolin and systemic steroid
The best management for this 4-year-old child, who presents with signs of likely acute asthma exacerbation (characterized by shortness of breath, wheezing, and low oxygen saturation) and a history of multiple hospitalizations for the same issue, is to administer Ventolin and systemic steroids. These treatments are standard for managing acute asthma exacerbations.
Answer for screen readers
The best management for this 4-year-old child, who presents with signs of likely acute asthma exacerbation (characterized by shortness of breath, wheezing, and low oxygen saturation) and a history of multiple hospitalizations for the same issue, is to administer Ventolin and systemic steroids. These treatments are standard for managing acute asthma exacerbations.
More Information
The child’s low oxygen saturation (82%) and history of respiratory issues suggest an asthma exacerbation. Ventolin (a bronchodilator) helps relax the muscles of the airways, and systemic steroids reduce inflammation, both of which are critical in managing asthma attacks.
Tips
A common mistake is to administer antibiotics, but they are not needed unless a bacterial infection is suspected. Focus on immediate relief with bronchodilators and reducing inflammation with steroids.
Sources
- Asthma and other recurrent wheezing disorders in children (acute) - pmc.ncbi.nlm.nih.gov
- Oxygen saturation targets for children with respiratory distress - pmc.ncbi.nlm.nih.gov
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