Consultant review

Your consultant attends, examines Jack and asks you to give an adrenaline nebulizer immediately, and as soon as this is complete, give some intravenous dexamethasone. If he gets any worse, he asks you to call the paediatric intensive care team.

Jack again dislikes the mask and cries during the time he is breathing the nebulized medicine.

He rapidly improves and his breathing sound also improves.

You prescribe the dexamethasone and site a cannula. During the procedure Jack becomes much more upset but does not develop worsened breathing.

During the next hours Jack deteriorates again, and so you call the team from paediatric intensive care who attend quickly. They review him and note also the normal radiograph. He is given a second adrenaline nebulizer and taken to PICU.

You hear later that he was intubated because of his breathing difficulty.