A 4 y/o F presents the Emergency Department with a fever and cough, as well as 3 episodes of vomiting this morning. Vitals at triage are as follows: T 40.1 HR 140 BP 92/60 RR 30 SpO2 94% on RA. Multiple attempts at IV insertion have been attempted without success, and you successfully achieve an IO line. She has been in the department for 10 minutes and now has her first fluid bolus running. A capillary glucose check is normal. What is the best next step?

About the Author: Anton Helman

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.