A 3-year-old who experienced a near-drowning incident shows return of spontaneous circulation. What is the highest priority intervention upon arrival at the ED?

In a scenario involving a 3-year-old who has experienced a near-drowning incident and shows return of spontaneous circulation, the highest priority intervention is to auscultate breath sounds over the epigastrium and lung fields. This is crucial because children who have experienced near-drowning are at high risk for pulmonary complications due to the aspiration of water.

Auscultation allows for the assessment of lung function and identification of potential issues such as fluid accumulation or atelectasis, which could significantly impact the child's respiratory status. Understanding the breath sounds can provide immediate insight into whether the lungs are functioning adequately or if there are signs of distress requiring urgent intervention.

While other interventions, such as administering sedation, utilizing length-based resuscitation tapes, or obtaining a blood glucose reading, are important in their own right, they do not take precedence over assessing and ensuring that the child’s airway and breathing are stable. In emergency situations, prioritizing interventions that evaluate and support the respiratory system is essential for the survival and stability of pediatric patients, particularly after a high-risk event like a near-drowning.