A 3-week-old female presents to the ER with one week history…

A 3-week-old female presents to the ER with one week history of nasal congestion and occasional cough. She developed a fever to 102 F this evening, is refusing to feed, and mom reports coughing, noisy and fast breathing. On exam, she is ill-appearing, lethargic, tachypneic with intercostal retractions and a paroxysmal cough. Mom informs you that she also has a 2-year-old who is in day care and has a “cold”. What is the most likely diagnosis given the clinical presentation?

You are taking care of a 14 y/o with status asthmaticus. He…

You are taking care of a 14 y/o with status asthmaticus. He is currently intubated and sedated and being treated with continuous albuterol, steroids, and a cisatracurium and ketamine infusion. His current ventilator settings show a PIP of 36, PEEP of 5, TV 6 cc/kg, RR of 12, iTime 1.5, and FiO2 of 45%. A plateau pressure is measured and is 22. His most recent arterial blood gas is 7.08/80/65 and his EtCO2 reads 50.  What would be the most appropriate next step in managing this patient?