Nebulized adrenaline

You review Jack and see that he has deteriorated a little after the injection. Although this might be his upset, it may also be a deterioration of his condition.

You prescribe some adrenaline via nebulizer and this is given to Jack. He objects to the nebulizer but you help his parents hold it in position while it is delivered and tell them that as he cries, it helps bring the medicine into the lungs.

At the end of the nebulizer you review him.

HR 175/min, RR 30/min, T 37.5 C, SaO₂ 96% in Oxygen.

He is still a little upset, but his breathing is notably better with no sternal recession and added breathing sounds.

You suggest that they let him eat and drink as he would like and that you will be back to review him in 3 hours.

After 4 hours you return to see him again.

Jack has had a bottle of milk and looks much brighter now. You decide to examine him.

HR 102/min, RR 25/min, T 37.1 C, SaO₂ 98% in Oxygen.

His chest recession is now all but gone at rest and you cannot hear his respiratory noise at rest. His cough is a little quieter.

His chest is clear and breath sounds are equal.

You ask the parents if they are now happy to take him home. They are a little worried that he might get worse again, but will bring him back if he gets worse again.

They thank you for your care and attention.