A 10 year old male child presents to the Emergency Department with respiratory distress. The child is on a monitor as displayed. 

HPI:

The child presents with a sudden onset of shortness of breath, cough and rash. The child is allergic to tree nuts and has had previous episodes of respiratory distress. There are known sick contacts.

PMx:

The child's immunizations are delayed. There is a family history of food allergies. The child is following a normal growth curve. There is no history of eczema.

O/E:

The child is in marked respiratory distress with audible inspiratory and expiratory stridor. The child has a pruitic rash.