Questions: After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now unresponsive to painful stimulation. - His respirations are shallow, at a rate of 10 / min. - His oxygen saturation is 94% on 2 L of nasal cannula oxygen. - On examination, the child is snoring with poor chest rise and poor air entry bilaterally. What action should you take next? CHOOSE THE CORRECT ANSWER Increase nasal cannula flow Perform endotracheal intubation Reposition the patient and insert an oral airway Administer naloxone

The answer is: Reposition the patient and insert an oral airway.

Explanation for each option:

1. Increase nasal cannula flow: While increasing the oxygen flow might improve oxygenation, it does not address the primary issue of airway obstruction, as indicated by the snoring and poor chest rise.

2. Perform endotracheal intubation: This is a more invasive procedure and may be necessary if less invasive measures fail. However, it is not the first step in managing a patient with signs of airway obstruction.

3. Reposition the patient and insert an oral airway: This is the correct answer. The child is snoring, which suggests partial airway obstruction. Repositioning the patient and inserting an oral airway can help to open the airway and improve ventilation.

4. Administer naloxone: Naloxone is used to reverse opioid overdose. Diazepam is a benzodiazepine, not an opioid, so naloxone would not be effective in this situation.

Summary: The most appropriate initial action is to reposition the patient and insert an oral airway to address the airway obstruction and improve ventilation.