Question

A pale and very sleepy but arousable 3-year-old child with a history of diarrhea is brought to the hospital. Primary assessment reveals a RR of 45 bpm with good breath sounds bilaterally. HR is 150 bpm, BP is 90/64 mmHg, and SpO2 is 92% on room air. Capillary refill is 5 secs and peripheral pulses are weak. After placing the child on a nonrebreathing face mask (10-L/min flow) with 100% oxygen and obtaining vascular access, what is the most appropriate immediate treatment for this child?

Answer 1

The most appropriate immediate treatment for a pale and sleepy child with signs of dehydration and respiratory distress is to provide intravenous fluids to restore hydration and improve blood pressure and perfusion. Supplemental oxygen via a nonrebreathing face mask with 100% oxygen should also be provided to improve oxygenation.

Step-by-step explanation:

The child in this case is presenting with signs of dehydration along with respiratory distress. The history of diarrhea and the pale and sleepy appearance indicate that the child may be suffering from dehydration. The vital signs also support this, with a low blood pressure, weak peripheral pulses, and delayed capillary refill. The low oxygen saturation suggests that the child may have respiratory compromise as well.

The most appropriate immediate treatment for this child would be to provide intravenous fluids to restore hydration and improve blood pressure and perfusion. This can be done by administering an isotonic fluid such as normal saline. Additionally, since the child has respiratory distress, providing supplemental oxygen via a nonrebreathing face mask with 100% oxygen would help improve oxygenation.

By addressing the underlying dehydration and providing oxygen, the child's respiratory distress and overall condition can be improved.