A 3-year-old child is noted to have noisy breathing with high-pitched wheezes. What medication should be administered first?

In the situation presented, the child is experiencing noisy breathing characterized by high-pitched wheezes, which suggests the presence of bronchospasm often associated with conditions like asthma or reactive airway disease. Inhaled beta-agonists, such as albuterol, are commonly used to relieve bronchospasm quickly. They work by relaxing the muscles around the airways, allowing for easier airflow and alleviating wheezing and difficulty in breathing.

When a child presents with wheezing, administering an inhaled beta-agonist should be the first line of treatment because it acts promptly to open the airways. This rapid action can improve the child’s respiratory status significantly, making it essential to address wheezing symptoms effectively and swiftly.

While humidified oxygen may help with overall comfort and respiratory support, it does not directly address the underlying bronchospasm. Oral steroids, while important in managing inflammation in persistent wheezing or worsening asthma, take longer to exert their beneficial effects and are not immediately effective for acute symptom relief. Nebulized magnesium sulfate may also be used in certain cases of severe asthma exacerbation but is not a first-line treatment compared to inhaled beta-agonists. Therefore, the most appropriate initial treatment in this scenario is the inhaled beta-