University of Nebraska Medical Center
Omaha, NE USA
A 32-year-old healthy meat packing plant worker was hospitalized for shortness of breath. He normally worked on the kill floor of a local pork processing plant. On the day he was seen he had been reassigned, just for the day, to the room where brine was mixed and hams were placed into it for curing. The hams were smoked after the curing and were not smoked in that room. He developed shortness of breath and he was taken to the Nebraska Medicine emergency room.
He was a native of Myanmar and spoke English poorly. Physical examination revealed a man who appeared to be about the stated age severely short of breath with a respirator rate of 36-40 breaths/min. He was febrile at 38.6° C and tachycardic at 116 beats/min. His physical examination was otherwise normal except for a question of rales at the bases.
Which of the following should be done initially? (click on the correct answer to be directed to the second of 6 pages)