Nebulized salbutamol

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 salbutamol 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 42/min, T 37.2 C, SaO₂ 95% in Oxygen.

He is still a little upset, and his breathing is no better than before the salbutamol.

His parents are getting anxious – there have been two things that you have done, but he is no better than when he came into the hospital.

You ask your consultant to review Jack, and the consultant will come to see him when he has finished seeing a patient on the ward.

After 2 hours you return to see him again with the consultant.

Jack is looking a little brighter now and has had a bottle of milk. You decide to examine him.

HR 112/min, RR 28/min, T 37.2 C, SaO₂ 96% 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.

The consultant asks 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 both for your care and attention.