A 4-year-old child presents with wheezing and hypoxia. What treatment should the specialist initiate?

In the scenario of a 4-year-old child presenting with wheezing and hypoxia, the most appropriate initial treatment is oxygen therapy, which addresses the immediate need to improve the child's oxygenation status. Wheezing often indicates underlying airway obstruction or reactive airway disease, which can lead to inadequate oxygen exchange in the lungs. Providing supplemental oxygen helps ensure that the patient receives adequate oxygen, especially in the presence of hypoxia.

While bronchodilator therapy could be important as part of the management, particularly if bronchospasm is a contributing factor to wheezing, it would typically run alongside the initial strategy of stabilizing the child’s oxygen levels. Similarly, inhaled corticosteroids and mucolytic therapy play roles in the long-term management of conditions such as asthma or cystic fibrosis, but are not suited as immediate interventions in acute situations involving wheezing and hypoxia.

Thus, starting with oxygen therapy is crucial for addressing the hypoxia, ensuring that the child’s oxygen saturation levels are normalized before further interventions are considered to manage the underlying cause of wheezing.