A 2-year-old with a two-day cold, barking cough, inspiratory stridor, and SpO2 98% on room air is being transported. What should you prepare for?

• A. Respiratory arrest
• B. Sepsis
• C. Emesis
• D. Airway obstruction

Answer: (D)

Airway obstruction is the risk to prepare for. In a toddler with a two-day cold, barking cough and inspiratory stridor, this pattern suggests croup with swelling of the upper airway. Even though SpO2 is currently 98% on room air, small children have very narrow airways and edema can progress rapidly, leading to sudden obstruction. During transport, vigilance is essential because deterioration can occur quickly, so be ready to manage the airway: keep suction available, monitor for increasing work of breathing or muffled/absent breath sounds, and be prepared to provide supplemental oxygen or escalate to advanced airway support if signs of obstruction worsen. The other options don’t fit this scenario as well—there’s no current evidence of respiratory arrest, sepsis, or a primary risk for emesis in this presentation.