A 10-year-old boy with a history of asthma is brought to the Emergency Department for shortness of breath, cough, subjective fever, and rhinorrhea. His mother has been administering albuterol nebulizer treatments at home with little relief. His initial vital signs are as follows: heart rate 110 beats/minute, respiratory rate 15 breaths/minute, blood pressure 100/60 mm Hg, and oxygen saturation 93% on room air. On examination, the patient has intercostal and supra-costal retractions, poor inspiratory effort, and minimal wheezing in both lungs. He has a history of multiple hospitalizations for asthma exacerbation and has been intubated once for respiratory failure because of asthma exacerbation. What is the most appropriate intervention at this time?

A 10-year-old boy with a history of asthma is brought to the Emergency Department for shortness of breath, cough, subjective fever, and rhinorrhea. His mother has been administering albuterol nebulizer treatments at home with little relief. His initial vital signs are as follows: heart rate 110 beats/minute, respiratory rate 15 breaths/minute, blood pressure 100/60 mm Hg, and oxygen saturation 93% on room air. On examination, the patient has intercostal and supra-costal retractions, poor inspiratory effort, and minimal wheezing in both lungs. He has a history of multiple hospitalizations for asthma exacerbation and has been intubated once for respiratory failure because of asthma exacerbation. What is the most appropriate intervention at this time?

An 11-year-old patient who was in a severe motor vehicle collision and sustained multiple fractures and a potential traumatic brain injury (TBI) presents to the ED. The GCS is 5. Multiple direct and video laryngoscopy intubation attempts with in-line cervical spine stabilization have been unsuccessful. What is the most appropriate next step for this patient?

You receive a call that a school bus has collided with a tractor-trailer. The estimated number of injured children is 20, with 5 recognized as unstable and including open lower extremity fractures, unresponsive with suspected traumatic brain injury, abdominal injuries of impalement, etc. Which of the following statements regarding field triage of pediatric trauma patients is accurate?

Your hospital is preparing to obtain a level 1 pediatric trauma center designation and is currently reviewing their resources. Your center admits about 200 injured children below the age of 15 annually. It has one board-certified pediatric surgeon, 24-hour subspecialty coverage for neurosurgery, plastic surgery and PICU. It has a PED, pediatric acute care unit, rehabilitation services, a pediatric social worker and a child-life program. The hospital has a respectable teaching and research program. What additional resources does your center need for a successful designation?

When a poison has been ingested by a child, the parents should be instructed to do which of the following first?