Nebulised Adrenaline

You decide to give some nebulised adrenaline. Jack again dislikes the mask and cries during the time he is breathing the nebulized medicine.

He rapidly improves and his breathing rapidly improves. Afterwards, he is reassessed:

HR 175/min, RR 35/min, T 37.2 C, SaO₂ 97% in Oxygen.

His chest recession is now very mild and it is hard to hear his respiratory noise at rest.

His chest remains clear and breath sounds are equal.

One hour later he is deteriorating again and you decide to 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.