Your patient is a 31-year-old female complaining of dizziness and difficulty breathing after being stung by a bee. You note that she is extremely anxious, and your physical examination reveals a rapidly developing urticaria to her shoulders, neck, and face. Your partner has administered oxygen via a nonrebreather, initiated IV access, placed the patient on the cardiac monitor, and administered epinephrine SC and diphenhydramine IV. Despite this, you also note that her voice is quickly becoming more hoarse and she has developed expiratory wheezes in all lung fields. HR = 128, BP = 100/70, RR = 20, SaO₂ = 99%. What should be your major concern at this point, and what is the most appropriate treatment?

Question

Quizplus · Accepted Answer

The development of hoarseness and expiratory wheezes suggest the possibility of laryngeal edema, which can rapidly progress to total airway occlusion and respiratory arrest. The best choice would be to intubate the patient immediately to secure the airway and prevent respiratory failure. Administering albuterol or epinephrine may provide temporary relief for bronchospasm, but they will not address the underlying issue of laryngeal edema. Hypotension may also be a concern, but it is not the primary issue at this time, and fluids and dopamine are not the appropriate intervention for laryngeal edema.

Your Patient Is a 31-Year-Old Female Complaining of Dizziness and Difficulty