Question

A 5-week-old boy with a 3-day history of vomiting is admitted to the hospital, a nasogastric tube is placed, 95 and the baby is scheduled for pyloromyotomy. The most appropriate initial management would be:

A. Identification and correction of severe metabolic abnormalities
B. Proceeding with immediate rapid-sequence induction and balanced anesthesia for surgery
C. Type and cross-match
D. Chest x-ray
E. Insertion of a Salem sump and suctioning in the supine and right and left lateral positions

Answer 1

The most appropriate initial management for the 5-week-old boy with vomiting and scheduled for pyloromyotomy is the insertion of a Salem sump and suctioning.

Step-by-step explanation:

The most appropriate initial management for a 5-week-old boy with a 3-day history of vomiting and scheduled for pyloromyotomy would be insertion of a Salem sump and suctioning in the supine and right and left lateral positions.

This initial management technique helps to relieve gastric distention by suctioning out stomach contents, preventing further vomiting and facilitating the surgical procedure.

Other options such as identifying and correcting severe metabolic abnormalities, proceeding with immediate rapid-sequence induction and balanced anesthesia for surgery, type and cross-match, or chest x-ray may be important during the overall management of the patient, but they are not the most appropriate initial management in this case.