First Things First (assess and treat)

  • Is there airway compromise?
    • Is there mucosal involvement? Are the lips or gums swollen?
    • Is there audible wheezing or stridor?
    • Is there tachypnea, grunting, flaring or retractions?
  • Is there hemodynamic instability?
    • Is the patient hypotensive?
    • Does the patient have delayed capillary refill?
  • Is this anaphylaxis?
  • Assess ABCs and support accordingly.
  • Once ABCs are stabilized, evaluate for neurologic disability and meningeal signs.
    • Consider meningococcemia early if a new rash preceded by mild upper respiratory infection is present in adolescent or college-age patients ± fever.

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Last updated: April 29, 2010