Intravenous dexamethasone

You site a cannula and prescribe a dose of intravenous dexamethasone, and this is given to Jack. He cries a lot when the cannula is sited, and this makes his breathing noise much worse, but calms down once it is taped to his skin.

After the injection you review him. 

HR 150/min, RR 40/min, T 37.5 C, SaO₂ 95% in Oxygen. 

He is still a little upset and there is no real difference in his breathing to that before the injection.

After 3 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.