Consultant review

Your consultant attends, examines Jack and asks you to give a second adrenaline nebulizer immediately, and as soon as this is complete, give some intravenous dexamethasone.

He also 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 sounds also improve.

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

You then call the team from paediatric intensive care who attend quickly. They review him and note also the normal radiograph. He is taken to PICU.

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