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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