A 6-year-old female is in severe respiratory distress with inspiratory stridor and pale moist skin with cyanosis noted around his mouth. He is very lethargic and cannot hold his head up. His mother is panicked and reports that he has a history of asthma. Breath sounds are diminished and his vital signs are: pulse 162, respirations 40, blood pressure 122/66, and SpO₂ 81%. Your immediate action would be to:

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The patient is in severe respiratory distress with inspiratory stridor, which indicates upper airway obstruction. Applying a nonrebreather would not be effective in delivering oxygen to the patient due to the upper airway obstruction. Inserting an oral airway would further obstruct the airway and is contraindicated in a patient who is conscious and has an intact gag reflex. Administering an albuterol MDI would also not be effective in relieving the upper airway obstruction. The immediate action should be to start positive pressure ventilation with a bag-valve mask to try to overcome the obstruction and improve oxygenation. Immediate transport should also be initiated.

A 6-Year-Old Female Is in Severe Respiratory Distress with Inspiratory