Admit on salbutamol

Jack’s parents are pleased to be move out of accident and emergency. They expect that his problem is mostly asthma and will improve with the nebulizer. You give instructions to the nursing team to keep a close eye on his breathing and to contact the night paediatric team if he deteriorates.

The following morning you look in to see how Jack is getting on, as you are heading to the paediatric clinic. The ward staff say that he is not on the ward any more as he was moved to intensive care overnight.

Apparently his breathing became increasingly labored and the intensive care team reviewed him and took him to PICU. He is currently being ventilated, and has just had a bronchoscopy.

A small plastic toy (Lego®) was removed from his right main bronchus.