A 5-year-old Mexican boy whose vaccination status is unknown

Discussion in 'USMLE Step 2 CK' started by Kute., Sep 1, 2008.

  1. Kute.

    Kute. Guest

    A 5-year-old Mexican boy whose vaccination status is unknown is brought to the emergency department with sudden onset of high-grade fever, irritability and difficulty in swallowing. The patient was apparently normal before going to the bed but he awoke in the middle of the night with severe respiratory distress. His temperature is 39.1C(102.4F) and he is in obvious respiratory distress and found to be retracting his intercostals muscles. Saliva is coming out of the corners of his mouth. He feels better when he is sitting erect. What is the most appropriate next step in the management of this patient?

    A. Direct visualization of his pharynx by a tongue depressor
    B. Fiberoptic laryngoscope in the operating room
    C. Lateral neck film
    D. Emergency tacheostomy
    E. Nasotracheal intubation
    F. Administeration of IV ceftriaxone
    G. Administeration of racemic epinephrine

Share This Page