]> 2026-07-31T09:41:21+00:00 WBR0378 0 en IV antihistamine After the patient is intubated and her airway is secured, further management should be pursued such as antihistamines and IV steroids Call her primary care physician and ask about the name of the pill This is reasonable to do later when her PCP is available, however it is the not immediate step to be taken in such an emergency situation High dose IV steroids After the patient is intubated and her airway is secured, further management should be pursued such as antihistamines and IV steroids Endotracheal intubation Correct! IV normal saline The patient's blood pressure is stable at this time and does not need IV hydration. This patient is in severe respiratory distress with evidence of hypoxemia despite high flow oxygen, cyanosis and altered mentation. She most likely developed ACEI induced angioedema. The most important next step in management is intubation to save her life. You can then proceed with IV steroids and antihistamines. It’s also reasonable to call her primary care physician as soon as possible to confirm the diagnosis. IV normal saline will be of little use in treating this condition unless she develops hypotension.<br/> '''Educational Objective:''' <br/> '''References:''' Emergency Room Mahmoud Sakr M.D. 42 y/o female presents to the emergency room with rapidly progressive shortness of breath and wheezing. She’s cyanotic and disoriented. Her son is with her and provides you with some of her medical history. Her past medical history is significant for hypertension, diabetes and dyslipidemia. She was started yesterday by her primary care physician on a blood pressure medication, but her son cannot recall the name of the pill. Her vital signs are bp 123/92, RR 28, P 123, Temperature 37.2 C, O2 saturations are 82% despite high flow oxygen. On exam, she has stridor of the airway with gasping or wheezy inspiratory breath sounds. Which of the following is the most appropriate next step in management: D Allergy/Immunology Respiratory 2020-10-28T00:23:05Z 2459150.5160301 WBR0378