Which of the following would indicate a severe respiratory distress in a child during anaphylaxis?

Worsening airway swelling is a critical indicator of severe respiratory distress in a child experiencing anaphylaxis. During anaphylactic reactions, the immune system excessively responds to an allergen, leading to the release of various mediators that can cause significant swelling of the airways. This swelling can obstruct airflow, making it difficult for the child to breathe.

As the condition progresses, worsening airway swelling can lead to stridor, respiratory distress, and ultimately respiratory failure if not addressed promptly. Recognizing this sign is essential in the clinical setting, as it necessitates immediate intervention, such as administering epinephrine and securing the airway.

In contrast, stable heart rate, minimal swelling, and normal oxygen saturation do not indicate severe respiratory distress. A stable heart rate may suggest that the child is not in immediate cardiovascular distress, while minimal swelling and normal oxygen saturation do not reflect the potential respiratory compromise that could be occurring. Therefore, the presence of worsening airway swelling is a clear and urgent sign that the child's respiratory status is deteriorating, warranting immediate medical attention.