Once safely intubated orally, may switch to more secure nasotracheal tube if desired. CXR to verify tube position. If needed may sedate or paralyze and use mechanical ventilation. Significant respiratory compromise. Recurrent Emergency Department or clinic visits in 24 hours.
Patient lives a long distance from the hospital or has inadequate transportation.
Inadequate observation or followup is likely. Significant parental anxiety exists. If the patient has received a racemic epi. Phone followup must be assured a few hours later. Documentation of the phone call should be performed.