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A 5-year-old boy presents with dysphagia. He began complaining of a sore throat 5 hours ago and was unable to swallow solid food. He had gone to bed but awoke 3 hours later frightened, hot, and having difficulty breathing. On physical exam, his temperature is 103.2F, heart rate is 100, and respiratory rate is 42. The boy is frightened, sitting forward in his father's lap with his neck extended, and drooling with his tongue protruding from his mouth. Both inspiratory and expiratory stridor are prominent. Which of the following is the most appropriate next step in the management of this patient?

(A) Arterial blood gas analysis to assess degree of respiratory compromise
(B) Complete physical examination to identify other signs of illness
(C) Focused exam of oropharynx to identify the cause of his respiratory distress
(D) Immediate monitored transfer to the operating room for the placement of an artificial airway
(E) Immediate administration of aerosolized racemic epinephrine to reduce airway obstruction




can anybody explain???


this is epiglotittis , to prevent obstruction the management requires control of the airways, first. In obvious cases examination is avoided and also any kind of stimulation of the child.


thanks vallia.



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