A 12-year-old child with asthma emerging from general anesthesia after tonsillectomy develops wheezing and stridor; the perioperative nurse can anticipate assisting the anesthesia professional with which action first?

• A. Suctioning the airway
• B. Setting up an aerosol mask with 2.5% racemic epi
• C. Administering Solu-Medrol 2mg/kg IV
• D. Reintubating the child

Answer: (A)

Maintaining airway patency is the immediate priority when a child emerges from anesthesia with wheezing and stridor. Suctioning the airway to remove blood, mucus, or secretions that contribute to obstruction can rapidly improve ventilation and oxygenation, making it safer to assess and treat the bronchospasm or edema that may be present. By clearing the airway first, you enable effective delivery of any subsequent therapies (bronchodilators, racemic epinephrine, or steroids) and reduce the risk of hypoxia.

After suctioning, the anesthesia provider may proceed with medications such as bronchodilators or anti-inflammatory agents and, if airway obstruction remains significant, consider other measures like nebulized epinephrine or steroids. Reintubation is reserved for cases where airway patency cannot be restored or maintained.