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December 2008, Volume 38 Number 12 , p 72 - 72


  • Heather Brown-Guttovz RN, BSN
  • Farmington Hills Mich.


Brown-Guttovz, Heather RN, BSN; Hills, Farmington Mich.

Issue: Volume 38(12), December 2008, p 72 Publication Type: [Feature: Action STAT] Publisher: © 2008 Lippincott Williams & Wilkins, Inc.

ACCOMPANIED BY HIS MOTHER, Liam O'Neill, 16, arrives at your ED complaining of difficulty breathing, coughing, and wheezing that started about 2 hours ago. He appears anxious and short of breath and can talk only in phrases. You help him to a bed and attach him to a cardiac monitor and pulse oximeter. His vital signs are: BP, 140/74; respirations, 28; temperature, 98.6° F (37° C); and SpO 2 , 90% on room air. His cardiac rhythm is sinus tachycardia at 120 beats/minute.

What's the situation?

Liam says his symptoms began shortly after arriving at a friend's house. His mother tells you Liam's friend recently acquired a cat, and Liam has a history of asthma and environmental allergies (including pet dander) since age 4. He has no known drug allergies or other medical problems. His mother tells you ...

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