A 23-year-old man presents to the emergency department with shortness of breath. The patient was at a lunch hosted by his employer. He started to feel his symptoms begin when he started playing football outside with a few of the other employees. The patient has a past medical history of atopic dermatitis and asthma. His temperature is 98.3°F (36.8°C), blood pressure is 87/58 mmHg, pulse is 150/min, respirations are 22/min, and oxygen saturation is 85% on room air. Which of the following is the best next step in management?
AAlbuterol and prednisone
BIV epinephrine
CIV fluids and 100% oxygen
DAlbuterol and norepinephrine
EIM epinephrine
A 45-year-old woman, suspected of having colon cancer, is advised to undergo a contrast-CT scan of the abdomen. She has no comorbidities and no significant past medical history. There is also no history of drug allergy. However, she reports that she is allergic to certain kinds of seafood. After tests confirm normal renal function, she is taken to the CT scan room where radiocontrast dye is injected intravenously and a CT scan of her abdomen is conducted. While being transferred to her ward, she develops generalized itching and urticarial rashes, with facial angioedema. She becomes dyspneic. Her pulse is 110/min, the blood pressure is 80/50 mm Hg, and the respirations are 30/min. Her upper and lower extremities are pink and warm. What is the most appropriate management of this patient?
AAdminister broad-spectrum IV antibiotics
BAdminister vasopressors (norepinephrine and dopamine)
CAdminister IM epinephrine 1:1,000, followed by steroids and antihistamines
DPerform IV resuscitation with colloids
EObtain an arterial blood gas analysis
A 6-year-old boy is brought to the emergency room by ambulance, accompanied by his kindergarten teacher. Emergency department staff attempt to call his parents, but they cannot be reached. The boy’s medical history is unknown. According to his teacher, the boy was eating in the cafeteria with friends when he suddenly complained of itching and developed a widespread rash. Physical exam is notable for diffuse hives and tongue edema. His pulse is 100/min and blood pressure is 90/60 mmHg. The boy appears frightened and tells you that he does not want any treatment until his parents arrive. Which of the following is the next best step in the management of this patient?
AImmediately administer epinephrine and provide supportive care
BContinue calling the patient’s parents and do not intubate until verbal consent is obtained over the phone
CObtain written consent to intubate from the patient’s teacher
DWait for the patient's parents to arrive, calm the patient, and provide written consent before intubating
EObtain written consent to intubate from the patient
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