What is the first step in the management of lower airway obstruction in PALS?

In the management of lower airway obstruction, especially in pediatric advanced life support (PALS), the initial focus is on ensuring the airway is clear and free from secretions that can cause further obstruction. Suctioning as needed is key because it can swiftly remove mucus or other obstructions that inhibit airflow, allowing for improved ventilation and oxygenation. This step is crucial before administering medication or other interventions, as clearing the airway takes precedence to optimize subsequent treatments.

Addressing airway patency is vital, particularly when dealing with conditions like asthma exacerbations or bronchospasm, where secretions can compound the issue. While other interventions, such as administering nebulized albuterol or oxygen, may be necessary, they are more effective once the airway is cleared. Therefore, initiating with suctioning is the correct first step in this scenario.